Finish Line Application

SSU ID Number

Planned Re-Enrollment Term:

Do you plan to pursue your degree completely online?

Intended Field of Study

First Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Home Phone

Email Address

Hispanic

Ethnicity

Citizenship

Resident Status for Past 12 Months:

Kentucky County

Dates Lived in Ohio:

From:

To:

Have you attended college since last attending Shawnee State University?

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Institution
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Have you ever been convicted of any crime where you were adjudged a sex offender in any state?

If yes, State of Conviction:

Year of Conviction:

Have you been convicted of a felony?

If yes, State of Conviction:

Year of Conviction:

Are you a Veteran, on Active Duty, a member of the Reserves or National Guard, or No Military?

Are you a Spouse or dependent of a Veteran, or a service member on Active duty, Reserves or National Guard?