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RIT Application for Undergraduate Online Study

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Personal Information

First Name *
Middle Name
Last Name *
Previous Name(s)
E-mail *
Date of Birth (MM/DD/YYYY) *
Telephone (Home) *
Telephone (Mobile)
Have you ever attended RIT? Yes    No   
If yes, when?

Mailing Address

Address *
Address 2
City *
State (U.S.) *
ZIP (Postal) Code *

Educational Goals

Program of Choice *
In which calendar year and academic term do you plan to enroll in? * Calendar Year: Fall    Spring    Summer   
Are you applying for Full-time or Part-time study? * Full-time
Part-time   

Education Information

Please list all universities and graduate schools you have attended or are currently attending.

Name of high school or GED-granting institution High School/GED City High School/GED State Completion Date Last Name(s) Used While In Attendance
Type of Diploma Name of Institution City State Dates Attended (MM/YYYY - MM/YYYY)
If currently enrolled, name of the institution
If additional institutions have been attended, please enter the institution names separated by commas

Employment Information

Name of Current Employer
Employer Address
Employer City
Employer State
Employer Zip
Are you eligible for tuition reimbursement or tuition assistance from your employer? Yes    No   

Additional Information

Gender Male    Female   
Are you a U.S. Citizen or permanent resident? Yes    No   
If you are currently in the United States, please indicate any type of visa you have: Student (F)    Exchange Visitor    Other   
City and Country of Birth
Are you eligible for veteran’s benefits for your college education? Yes    No   
Do you plan to apply for financial aid? Yes    No   
Are you an RIT employee or dependent of an RIT employee? Yes    No   

Personal Conduct

Have you ever been subjected to disciplinary action by any school, college, university, or branch of the military (If yes, briefly explain below.) * Yes    No   
Explanation
Have you ever been convicted of a violation of any state or federal law, excluding minor traffic violations? (If yes, briefly explain below.) * Yes    No   
Explanation
Are you receiving or seeking support services from RIT’s National Technical Institute for the Deaf? * Yes    No   

Optional Title VI Information

Race/ Ethnic Origin (check all that apply) American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White


* Required field

When you submit this completed form, it is considered a complete full application and you should not complete another application online. Doing so creates duplicates that could cause a delay in processing your application.