Office of Admissions PO Box 1773 Carlisle, PA 17013 (800) 644-1773 Fax (717) 245-1442 admit@dickinson.

edu

Part I: The Dickinson College Supplemental Form

Please complete and return this form with the Dickinson Application (the Common Application), by the appropriate admission application deadline. Your application will NOT be considered complete without receipt of this completed form AND the required statement (#4). Use of the Common Application is governed by the License Agreement for Common Application Forms, a copy of which is displayed at www.commonapp.org. Please read this Agreement carefully before using the Common Application. 1. PERSONAL DATA

Legal Name:
Last/Family First Middle Jr., etc. Preferred Name

Date of Birth: Permanent Home Address:

Number and Street

Social Security Number:

Please detach along perforation

City or Town

State

Country

Zip Code or Postal Code

Secondary School:
Name State/Country CEEB

2. ADMISSION PLAN

I am applying under the following first-year admission plan: Early Decision I deadline: November 15 (a signed Early Decision Agreement Form is required) Early Action deadline: December 1 Early Decision II deadline: January 15 (a signed Early Decision Agreement Form is required) Regular Decision deadline: February 1 International applicants, please note that the International Student Certification of Finances form is required of all international applicants by the deadline selected.
I I I I

3. FOR FINANCIAL AID APPLICANTS I I understand that I must complete and submit the CSS PROFILE by the admission deadline I have indicated above. I also

understand that I must submit the Free Application For Federal Student Aid (FAFSA) after January 1. I have filed/will file the CSS PROFILE on: __________________________
FOR INTERNATIONAL FINANCIAL AID APPLICANTS I I understand that in addition to the International Student Certification of Finances (COF) form, I also must submit the

International Student Financial Aid Application (ISFAA) by this application deadline. I have filed/will file these forms on: __________________________

4. REQUIRED STATEMENT (Please attach an additional page.)

In addition to curriculum, grades and activities, Dickinsons Admissions Committee looks for purpose, potential and selfreflection. Explain why you have chosen to apply to Dickinson and how your interests, talents and goals fit with Dickinsons distinctive character.
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5. TEST INFORMATION I Check if you do not wish your SAT I or ACT scores to be reviewed for admission.

6. FAMILY

In addition to your parents and any siblings you listed in the Common Application, please provide the name, relationship, and dates of attendance of any other relative who has attended Dickinson College (include former last names if applicable).

Name of Relative

Relationship

Dates of Attendance

Name of Relative

Relationship

Dates of Attendance

7. ACADEMIC INTEREST

Please indicate your area of academic interest.

I I I I I I I I I I I I

Africana Studies American Studies Anthropology Archaeology Art (studio) Art History Biochemistry & Molecular Biology Biology Chemistry Classical Studies Computer Science Dance & Music

I I I I I I I I I I I

Earth Sciences East Asian Studies Economics English Environmental Science Environmental Studies French & Francophone Studies German History International Business & Management International Studies

I Italian Studies I Judaic Studies I Latin American, Latino

& Caribbean Studies

I Law & Policy I Mathematics I Medieval & Early I I I I I

Modern Studies Middle East Studies Music Neuroscience Philosophy Physics & Astronomy

I I I I I I I I I

Policy Management Political Science Psychology Religion Russian Sociology Spanish & Portuguese Theatre & Dance Womens & Gender Studies

I Undecided I Self-Developed Major

Please indicate interest in the following certificates or programs. I Army ROTC I Health Studies

I Secondary Teaching

I Security Studies

If you are interested in preprofessional advising, please check your area of interest below. I Business I Engineering I Health

I Law

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