Application for Admission

Personal Information

First Name:

Middle Name:

Last Name:



Type of phone:
Home Work Cell
Can we text you?






Male Female

Birth date:

Birthplace City:

Birthplace County:

Birthplace State:

US Citizen
US Permanent Resident
Non-Resident Alien

Country of Citizenship (if not US citizen):

If you are a non-resident alien, please indicate the non-resident visa status you currently hold:
I require a student visa     I require a change of status
(clear visa fields)

I am requesting transfer to your campus from:

What race do you consider yourself to be?:*
African American/Black
Alaskan Native or American Indian
Native Hawaiian or Other Pacific Islander
Two or More Races
Race and Ethnicity Unknown

Are you a veteran?:
Yes No

Will you be using VA Benefits, Yellow Ribbon or applying for Veteran's assistance to help cover your tuition?:
Yes No


Admission Information



How did you hear about us:


Emergency Contact

Full name of contact:





Certification & Disclosure

Statement of Disclosure: Have you ever been charged with or convicted of any felony or misdemeanor (other than minor traffic violations) including juvenile charges, drug and alcohol offenses, deferred prosecutions/judgments, and expunged convictions?:
Yes No

I certify that all information contained in this application is factually correct and complete. I understand that the omission or misrepresentation of any information, including enrollment in other colleges or universities, may void my admission or result in dismissal. *


eSign Application

First and Last Name required


By clicking above, I consent to receive calls and/or text messages* by a university representative with information for educational opportunities at the number(s) provided above. I understand calls may be initiated by an automated telephone dialing system. I need not grant this consent to receive information or to be eligible to enroll with WCU. I also understand that if I no longer wish to receive text messages from WCU, I can text back "Stop" at any time to unsubscribe from the service. *Standard rates may apply.

Security and Fire Safety Information - Annual Security Report: West Coast University is committed to partnering with students, faculty and associates to create a safe campus community. Information regarding campus security as well as personal and fire safety, that covers topics such as Campus Security Authorities; disciplinary procedures; and crime prevention, reporting, and statistics for the most recent three-year period, is available at You may also request a paper copy of the report by sending your request to

Note: calls may be recorded for quality assurance purposes.

* Required Fields

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