Program Application

Complete the application below to begin your journey with eHBCU.

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Section 1: Personal Information

First Name:*

Middle Initial:

Last Name:*

SSN:

Social Security Number Disclaimer – Providing your SSN is voluntary and used for record identification, financial aid processing, and required reporting. The University protects your SSN under FERPA and applicable laws and limits access to authorized personnel only.

Address:*

Address Line 2:

City:*

State/Province/Region*

Zip/Postal Code:*

Country:*

Gender:*

Preferred First Name:

Pronoun:*

Date of Birth:*

Race/Ethnicity

Citizenship:*

Section 2: Enrollment Details

Institution Selected:*

Program of Study Selected:*

How did you hear about us?*

Student Type:*

Start Term:*

Start Year*

Section 3: Contact Information

Mobile Number:*

Email*

Preferred Contact:*

Section 4: Academic Background

High School CEEB Code Lookup

College/University CEEB Code Lookup

Highest Education Completed:*

Enter High School CEEB Code*

Use the High School link above to locate your High School CEEB code and enter.

Enter College CEEB Code:*

Use the College/University link above to locate your College or University and enter the CEEB code.

Last Institution's Cumulative GPA:*

9.999

Number of Transfer Credits*

Military Affiliation:*

Authorization to Release and Share Information:*

I authorize the release and sharing of my information with eHBCU and its consortium partners for the purpose of evaluating my admission eligibility, financial aid, and related educational services.

Agreement to Institutional Academic and Conduct Policies:*

If admitted, I agree to abide by the academic and student conduct policies of the institution in which I enroll.

Acknowledgment of Multi-Institution Review:*

I understand that my application may be reviewed by more than one institution, and that each school may follow its own admissions policies and timelines.

Acknowledgment of Consequences for Incomplete or False Information:*

I understand that withholding information or providing false information may result in the denial of admission or dismissal from any institution within the eHBCU College Consortium.

Certification of Accuracy and Completeness:*

By signing below, I certify that all information provided in this application is accurate and complete to the best of my knowledge.

Signature*