2023 Concurrent Enrollment Application Form

Personal Background

Name

Preferred First

First Name

Middle Name

Last Name

Suffix

Other Last Names Used

Address

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Same as Mailing Address

Country

Street

City

Region

Postal Code

Contact Information

Email Address

Home Phone

Mobile Phone

May we text you?

Yes

Biographical Information

Legal Sex

Personal Pronouns

Birthdate

Citizenship Information

Primary Citizenship

Dual Citizenship

Are you a U.S. Permanent Resident?

Yes

City of Birth

Birth country/region/territory

Social Security Number (omit dashes)

Academic Plans

Please use this section to outline your academic plans while at Westminster.

I plan to take courses in

Spring 2023

Fall 2023

High School Information

High School Name
Begin typing the name of your high school, followed by the state that you live in. Example: East, UT
Please only select from the options presented. If your high school is not listed, you can type it out here.

What grade are you in?

High School Counselor/Administrator Information

Counselor/Administrator First Name

Counselor/Administrator Last Name

Counselor/Administrator Title

Counselor/Administrator Email

Counselor/Administrator Phone Number

An email will be sent to your high school counselor/administrator upon submission of this application. Permission from a high school counselor/administrator is required in order for you to enroll in concurrent enrollment courses at Westminster.

Family Information

Parent or Legal Guardian Information

Relationship to you

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone Number

Do you reside with this person?

Yes

An email will be sent to your parent or legal guardian upon submission of this application to obtain their consent for your concurrent enrollment at Westminster.

2023 Concurrent Enrollment Application Form

About Westminster

Student Involvement

Community Resources

Institutional Information