Application for Admission

NOTE: For those applying to the WCU School of Pharmacy or one of the online programs, please click the appropriate application link below.

WCU School of Pharmacy
Online Programs

Personal Information

First Name:

Middle Name:

Last Name:

Email:

Phone:

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

Zip:

Address:

Apt./#:

City:

State:

Gender:
Male Female

Birth date:

Birthplace City:

Birthplace County:

Birthplace State:

Citizenship:
US Citizen
US Permanent Resident
Non-Resident Alien
Other:

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
Asian
Filipino
Hispanic/Latino(a)
Native Hawaiian or Other Pacific Islander
White
Other/No response

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

Program:

Campus:

How did you hear about us:

 

Emergency Contact

Full name of contact:

Address:

Phone:

Relationship:

 

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
Signature
Date

 

By clicking above, I consent to be contacted 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 understand if I do not wish to consent, I may call 866-508-2684 for more information.

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 westcoastuniversity.edu/safety-security.html. You may also request a paper copy of the report by sending your request to safetyandsecurity@westcoastuniversity.edu.

Note: calls may be recorded for quality assurance purposes.

* Required Fields