Adult/TAP

Application for Admission

SSN:	--
Name:
Address:
City:
State:
Zip Code:
Email:
Home Phone Number:	-
Alternate Phone Number:	-
Gender:	Male Female
Birth Date:	//
Are you a U.S. citizen?	Yes No
If not, country of cizitenship and type of visa:

Optional Information
Are you Hispanic or Latino?	Yes No
What is your race? (Check one or more)	White Black or African American Asian American Indian or Alaskan Native Native Hawaiian or other Pacific Islander

List in chronological order all colleges or universities attended:
Name of Institution	City/State	Degree	Dates Attended (From - To)

Recommendations/References (Family Members Not Accepted) Please list the names, job title, institution/school, and email addresses of three contacts for references. Information to complete the recommendations will be emailed to these individuals.
Name	Job Title	Institution/School	Email

Current employment (Job and Employer):

What is your content area?
Grade Level?
School?

Have you ever been convicted of a felony?	Yes No
If YES, please forward relevant information on the matter or refer questions to the Director of Admissions, 333 Thomas More Parkway, Crestview Hills, KY 41017-3495. Thomas More College is committed to maintaining a safe environment for all members of the College community. As a part of this commitment, we require applicants who have been convicted of a felony to disclose this information. Record of a previous conviction does not automatically bar admission to the College but does require review.

Security Question: What is 1 + 2?

In submitting this application, I certify that the information supplied is true and complete. Any falsification or omission may be grounds for denial of admission or for disenrollment. If I am accepted for admission and enroll as a student at Thomas More College, I agree to abide by the rules and regulations of the College. By completing this application, I understand that I will be considered for all academic and/or designated scholarships for which I may apply.