Dual Admission Application

More information on Dual Admission can be found on our website here. Please contact us at 419-448-2330 or admission@heidelberg.edu if you have any questions.

Personal Information

First Name (Given Name)

Middle Name

Last Name

Suffix

Preferred First Name

Former Last Name (Additional name that may appear on your records (i.e. maiden name, former married name))

Sex
Your response will not affect your admission decision.

Date of Birth

Country of Citizenship
Your response will not affect your admission decision.

Social Security Number (No dashes (-) in number. Required if applying for U.S. federal aid with the FAFSA form)

Contact Information

Preferred Telephone

Cell

Home

When entering your phone number, please begin your number with "+country code". For example, students from Germany would use "+49" followed by their phone number.

Cell Phone Number

Home Phone Number

Email Address

Address

Mailing Address

Country

Street

City

Region

Postal Code

Is your permanent home address the same as your mailing address?

Yes

No

Permanent Home Address

Country

Street

City

Region

Postal Code

Parent Information

This section is mandatory if you are under 18 years of age.

Parent/Guardian Relationship to you

Parent 1 First Name

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone Type

Parent/Guardian Phone

Is their address the same as yours?

Parent/Guardian Address

Country

Street

City

Region

Postal Code

Do you have another Parent/Guardian to list?

Yes

No

Parent/Guardian Relationship to you

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone Type

Parent/Guardian Phone

Is their address the same as yours?

Parent/Guardian Address

Country

Street

City

Region

Postal Code

Enrollment Information

Select your intended start term:

Application Type

Freshman

Transfer

Dual Enrollment with:

Heidelberg Major

Education Information

College/University Name

College/University Address

Country

City

Region

Postal Code

Dates Attended (mm/yy-mm/yy)

High School Name

Graduation Year

Name of High School Counselor

Optional Demographic Information

No information you provide in this section will be used in a discriminatory manner. This information is requested so that we can refer you to financial assistance available to students meeting certain designated criteria.

Marital Status

Religious Preference

Are you a member of the United Church of Christ?

Yes

No

Are you or your parent a US Armed Services Veteran?

Do you identify yourself as Hispanic or Latino?

Yes

No

Race/Ethnicity

Other Required Information

Have you ever been found responsible for a disciplinary violation at any secondary or post-secondary school, whether related to academic or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal or expulsion from the institution?

Yes

No

If Yes, please explain

Have you ever been found guilty of a misdemeanor, felony or other crime?

Yes

No

If Yes, please explain

Additional Materials Needed

Your completed application will be submitted to Heidelberg and the participating college selected for dual application. Please submit the following items to both your participating college and Heidelberg University:

Final high school transcript or GED
Official transcripts from any college previously attended (to be official, college transcripts must be sent from the previous college directly to your participating college and to Heidelberg University)

You may upload any of these items below. Alternatively, the documents can be emailed to admission@heidelberg.edu, faxed to 419-448-2334 or mailed to:

Heidelberg University
Office of Admission
310 E. Market St.
Tiffin, OH 44883

High School Unofficial Transcript

Most Recent College Unofficial Transcript

GED

Submission of Application

By clicking Submit (below), I affirm that the information presented in my application is complete and accurate to the best of my knowledge. I understand that any intentional omission or misrepresentation of information on this form could result in denial of admission or dismissal from Heidelberg University. I am aware that all transcripts submitted to Heidelberg in support of my application become the property of Heidelberg University.