MSU - Registrar's Office

Application for Status Change From Non-Degree to Degree Seeking

This form is to be used by students who have been previously admitted to Minot State University as a Non-Degree Seeking student and are intending to change their status to a Degree Seeking student. Students must have official transcripts mailed directly to the Registrar's Office from each school previously attended. If the student is transferring less than 24 semester hours, a high school transcript and ACT/SAT scores are also required. All transcripts must be received and processed by the Registrar's Office before the student can register for classes. This form must be submitted before the student registers. If the student registers for courses for the current semester before this form is processed, the student must remain Non-Degree until the following semester.

All Official Transcripts need to be submitted prior to enrolling for the term.

* Required fields

Social Security Number (last 4 numbers):*
Birthdate (Month/Year):*	mm/yyyy
Telephone #:*

Legal Name:
Last:*		First:*
Middle:		Former (if applicable):

Mailing Address:*
City:*	State/Province:*
Zip/Postal Code:*	E-Mail Address:**
County:	Country (if not USA):

** I authorize MSU to e-mail my MSU ID # to the email address I have provided.

Are you a North Dakota resident?*	Yes ...if yes, length of residency in years?
	No ...if no, state of residence?

Are you a U.S. citizen?* Yes No
If no, in which country do you hold citizenship?

If not a U.S. citizen, are you a permanent resident? Yes No (* - if applicable)
If yes, give alien registration number:

Gender : Male Female

Are you Hispanic/Latino?♦ Yes No
Select one or more races:♦

♦ NOTE: This information is requested for statistical purposes only and will not affect the status of your application. The information will not be used in a discriminatory manner and your response is voluntary.

Last term and year you attended MSU*	Year of last term:
Term and year you plan to re-enter MSU*	Year of re-entery:

Type of classes you are
planning on taking?

Undergraduate
Graduate (previously been admitted to Graduate School)

Academic Major:*
Minor (if applicable):

Are you applying to the Air University Associate to Baccalaureate Cooperative (AU-ABC) program? Yes No

Have you attended or are you currently enrolled in any other
colleges or universities?

Yes No

List all colleges, universities, and schools attended, whether or not credit was earned. Include college credits earned while in high school. Failure to list all colleges, universities, and schools previously attended may result in denial of admission, recision of admission, dismissal, loss of credit(s), or other appropriate sanctions.

Institution 1: School Name:

City: State/Province:

Inclusive Dates of Attendance:

Degree(s) Earned and Date:

Institution 2: School Name:

City: State/Province:

Inclusive Dates of Attendance:

Degree(s) Earned and Date:

Institution 3: School Name:

City: State/Province:

Inclusive Dates of Attendance:

Degree(s) Earned and Date:

Institution 4: School Name:

City: State/Province:

Inclusive Dates of Attendance:

Degree(s) Earned and Date:

Required Security Questions
All students making application must answer the following questions. An affirmative response to any of these questions will not automatically prevent admission, but you will be asked to provide additional information. The information will be reviewed by a campus officer or committee charged with that responsibility. Falsification or omission of information may result in a denial of admission, rescission of admission, dismissal, or other appropriate sanction.

Have you ever pled guilty (or no contest) to or been convicted on any felony?*
Yes No

Within the past 10 years, have you pled guilty (or no contest) to or otherwise been convicted of a misdemeanor crime involving violence or the threat of violence in any court?* "Crime of violence" means an offense that involves substantial risk that physical force may be used against a person or property of another. Examples of crimes of violence include, but are not limited to, abuse, arson, assault (including sexual assault or domestic violence) battery, breaking and entering, burglary, criminal mischief or vandalism, harassment, homicide, menacing, reckless endangerment, stalking, terrorizing and unlawful restraint or imprisonment.
Yes No

Are you currently required to register as a sex offender in any state?*
Yes No

Have you been dismissed or suspended from a college or university for disciplinary reasons within the last 5 years?* "Dismissed for disciplinary reasons" means a permanent separation from an institution due to conduct or behavior. "Suspended for disciplinary reasons" means a sanction imposed for disciplinary reasons that results in a student leaving school for a fixed period but not permanently.
Yes No

Go to www.ndus.edu to view the list of NDUS academic programs which require further criminal background checks. These may include nationwide FBI criminal history background checks or a criminal history background check which may be a North Dakota BCI check, nationwide check or check of another state or multiple jurisdictions.

Required Signature - I understand the information presented on this form will be used in evaluating my application for admission to Minot State University. I certify that all statements are complete and true as of this date. If this information changes, I will notify the Registrar's Office of the changes and understand that my admission status will be reevaluated at that time. I understand that I will need to complete orientation prior to enrolling for classes. Please allow at least 48 business hours for processing.

I accept the terms of this application.*