Application Form

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Thank you for your interest in Utica University.

Application fee (or waiver) applies

Existing Application

If you have already started your application, please log in using your e-mail address and the password that was sent to you.

Email Address *

Password *

Forgot Your Password?

* indicates required field

Program/Major

Note: Please use the links below if you are applying to one of the following:

M.S in Occupational Therapy
D.P.T. in Physical Therapy

Major/Program

Are you interested in pursuing an online program? *

Yes

Are you interested in pursuing undergraduate or graduate studies? *

Undergraduate

Graduate

Are you applying as a first year or transfer student? *

First Year

Transfer Student

Do you wish to apply for a certificate program? *

Yes

Do you wish to be considered for joint health professions programs? *

Yes

Program *

Major *

Concentration *

Site Location *

Biographical Information

First/Given Name *

Middle Name

Last/Family Name *

Suffix

Former Last Name

Gender *

Male

Female

Birthdate *

Month Day Year

Are you a U.S. citizen? *

Yes

Permanent Resident

Country of Birth *

Country of Citizenship

Number of years living in the U.S.

Do you have a current U.S. visa? *

Yes

Visa Type *

Is English your native language? *

Yes

What is your native, first, or dominant language?

How many years have you studied the English language? *

2-4

5 or more

Have you attended a school where English was used for instruction? *

Yes

School Name *

School Location *

Dates of Attendance *

Have you taken the TOEFL exam? *

Yes

Date of TOEFL Exam *

TOEFL Score *

Please have official score report sent to Utica University.

Have you taken the IELTS exam? *

Yes

Date of IELTS Exam *

IELTS Score *

Please have official score report sent to Utica University.

Please note that we must receive an official TOEFL or IELTS score report before we can offer admission to the IELP.

Social Security Number

First 3 Digits of Social Security Number - Middle 2 Digits of Social Security Number - Last 4 Digits of Social Security Number

Providing your U.S. Social Security Number allows the Admissions Office to process, track, and match your application credentials correctly and quickly. In addition, you are required (by the federal government) to provide your U.S. Social Security Number if you will be applying for federal financial aid. Utica University is dedicated to ensuring the confidentiality of students' records and application materials.

Agent *

Contact Information

Home Phone Number *

Home or cell phone number is required

Cell Phone Number *

Work Phone Number

E-mail Address *

Best Time to Contact You *

Current Mailing Address

Street Line 1 *

Street Line 2

Street Line 3

Zip Code *

City *

State *

City *

State *

Country *

At this address until (Optional)

(mm/dd/yyyy)

Please fill in this field only if you will be relocating in the near future.

Check if your permanent address is different from your current mailing address

Permanent Address (if different from above)

Street Line 1 *

Street Line 2

Street Line 3

Zip Code *

City *

State *

City *

State *

Country *

Phone Number (This address)

Optional Information

Response to the following items is voluntary and the information will be kept confidential. Refusal to provide this information will not subject the applicant to any adverse treatment.

Place of Birth

Mother's Country of Birth

Father's Country of Birth

The following items are optional. No information you provide will be used in a discriminatory manner.

Have you served in the US Armed Forces?

Yes

Branch of Service *

Are you Hispanic or Latino?

Yes

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Academic Interests

When do you plan to enroll? *

Are you Phi Theta Kappa?

Yes

When would you like to start the program? *

Have you applied to Utica University before? *

Yes

When did you previously apply?

I wish to study *

Full-time

Part-time

Early Decision

Applying as Early Action

If you are accepted under an Early Decision plan, you must promptly withdraw the applications submitted to other colleges and universities and make no additional applications to any other university in any country. If you are an Early Decision candidate and are seeking financial aid, you need not withdraw other applications until you have received notification about financial aid from the admitting Early Decision institution.

Yes, I have read and understand my rights and responsibilities under the Early Decision Process. I wish to be considered as an Early Decision candidate at Utica University. I also understand that with an Early Decision offer of admissions, this institution may share my name and my early commitment with other institutions. *

I plan to live *

This will be my second bachelor's degree

Yes

I am interested in applying to the Utica University Honors Program More Information

Yes

Have you ever enrolled in an HEOP/EOP program at any University or University? *

Yes

I wish to be considered for the Higher Education Opportunity Program (HEOP) * More Information

Yes

(Please note: HEOP is only for residents of New York State.)

Are you a first generation college student? * More Information

Yes

I am interested in the Utica University TRiO program *

Yes

Will you apply for financial aid? *

Yes

Are you currently in school? *

Yes

Are you a graduate of Utica University? *

Yes

If you have a ZeeMee account, what is your link?

Educational Data

High School CEEB Code *

Find School

School not found

College Name

Address

Zip Code

City

State

City

State

Country

Date of High School Graduation

High School Graduation Day High School Graduation Year

List all colleges/universities at which you have taken courses for credit. Please have official transcripts sent as soon as possible. List most recent degrees first.

College CEEB Code

Dates Attended

Credits Earned

Degree Earned

GPA

College 1

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 2

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 3

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 4

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 5

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 6

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

College 7

College CEEB Code

Find College

College not found

College Name

Address

Zip Code

City

State

City

State

Country

Dates Attended

Credits Earned

Degree Earned

GPA

Add Another College/University

List all secondary schools attended, including summer programs.

I choose to submit my test scores for consideration *

Yes

Have you taken or do you plan to take either the SAT or ACT?

Yes

Marital Status *

Single

Married

Separated

Divorced

Widowed

Family

Please list your parents and any guardian, brothers and sisters and, if applicable, your spouse and any children

Relative 1

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 2

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 3

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 4

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 5

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 6

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 7

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 8

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 9

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

E-mail Address

Relative 10

Relationship

Prefix

First Name

Middle Initial

Last Name

Suffix

Shares my address

Deceased

Mailing Address Line 1

Address Line 2

Address Line 3

Zip Code

City

State

City

State

Country

Home Phone Number

Work Phone Number

Cell Phone Number

Employer

Occupation

Degree

I reside with

Parents

Mother

Father

Other

Extracurricular and Personal Activities

Please list school activities, hobbies, or family and community activities in the order of their importance to you. Please check in the right column if you wish to pursue the activity at Utica University.

Activity

Years Participated

Positions held or letters or honors won (if any)

Participate in college?

Activity 1

Activity

Years Participated