{{error.message}}

{{previewTitle}}

 
▪ {{ errorMessage.text }}

Personal Information

 

 

Legal Name


First
Middle
Last
Suffix
{{ errorMessage.text }}

 

 

Former Name


{{ errorMessage.text }}

 

 

Preferred Name


{{ errorMessage.text }}

 

 

Sex


{{ errorMessage.text }}
Note: We are required by United States Federal guidelines to report the legal sex of each applicant as female or male. Typically, this is the sex indicated on the birth certificate or other official documentation issued to you. In the optional Gender field below, you may provide additional information about your gender/gender identity if you wish.
{{ errorMessage.text }}

 

 

Birthdate


{{ errorMessage.text }}

 

 

Languages


Languages ({{ data.rep_nqmzbixt5c.length }})
{{ errorMessage.text }}

 

 

Social Security Number


 
In accordance with state and federal law, the disclosure of your Social Security number is voluntary.

Please note that if you receive any form of federal aid (which includes student loans), you will be required to provide your social security number so that your aid may be processed.

Your number will not be disclosed to anyone outside of CUniversity except in accordance with CU policy on student records.

You will be assigned a ten-digit number that will be your University I.D. Your University I.D. number will be included in your admission letter from your department/school.

{{ errorMessage.text }}

 

 

Citizenship


{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}

 

 

Ethnicity


Please select all that apply
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}

 

 

Military Service


{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}

Contact Information



 

Email Address

Captisa University will contact you by email. Please provide an email address for an account you check regularly


{{ errorMessage.text }}
{{ errorMessage.text }}

 

 

Home and Mailing Addresses

Please provide your home address.


Street Address
Street Address Line 2
City
State
Country
Zip
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
Street Address
Street Address Line 2
City
State
Country
Zip
{{ errorMessage.text }}

 

 

Phone Numbers

Provide at least one phone number. If US based phone number, country code should be left blank.


{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
Would you like to receive text messages about your application to Captisa University and other important information related to the admissions process? Additionally, if you choose to attend CUniversity, we will also send you text messages about upcoming deadlines and other important information related to your enrollment. Text and data rates may apply.
{{ errorMessage.text }}

Family & Residency Information

 

 

Family Educational Experience


{{ errorMessage.text }}
{{ errorMessage.text }}

Academic Information

 

 

Academic Programs


{{ errorMessage.text }}

 

 

High School/Secondary School Information

What type of secondary schooling did/do you attend?


{{ errorMessage.text }}
{{ errorMessage.text }}
You indicated you were home schooled. Please answer the following questions concerning your home schooling.
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}
{{ errorMessage.text }}

 

 

Colleges & Universities Information


{{ errorMessage.text }}
{{ errorMessage.text }}
Please include all colleges and universities during or after high school, including any campus of CUniversity.

 

 

Extracurricular Activities

Please tell us about any extracurricular activities you have participated in


 

 

Gaps in Education


{{ errorMessage.text }}

Academic Goals

 

Header

Purpose for Attending Captisa University


{{ errorMessage.text }}

 

 

Enrollment Term


{{ errorMessage.text }}
{{ errorMessage.text }}

Additional Information

Application Completion


At Captisa University, we have two priority deadlines for fall admission: November 1 and February 1. However, you are highly encouraged to apply as soon as possible in the fall of your senior year of high school.
{{ errorMessage.text }}

 

 

Essay Question

Captisa University requires an essay as part of its application process. Provide a 200-400 word essay that addresses the question below. Acceptable formats are .pdf, .doc/.docx, and .txt files. (Maximum size 50MB)

Describe your academic and career plans and any special interests (e.g., undergraduate research, academic interests, leadership opportunities, etc.) that you are eager to pursue as an undergraduate at Captisa University. If you encountered any unusual circumstances, challenges, or obstacles in completing your education, share those experiences and how you overcame them.

This essay may be used for scholarship consideration.

{{file}}

Behavior

 

 

Behavioral Disclosure


We are committed to maintaining a safe learning environment. As part of that commitment, Captisa University requires applicants to disclose if they

 

  • have been subject to formal disciplinary action (including for example, but not limited to, suspension or expulsion for academic or non-academic reasons at any high school, post-secondary institution, college or university;
  • have been charged with or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court;
  • and/or have engaged in behavior that caused injury to person(s) or personal property (including for example, but not limited to, vandalism or behavior that led to a restraining order against you) which resulted in some form of discipline or intervention.

 

A previous disciplinary action, charge, conviction, or conduct of the sort identified here does not automatically disqualify applicants from admission to CU, but they do require review by the campus admissions committee. Furthermore, the review of any behavior disclosure information provided will be conducted independently of the evaluation of your academic eligibility for admissions and will only be shared with the admissions committee and/or with other officials at CU who have a need to know as part of the behavior review process.

PLEASE NOTE: By submitting your application to Captisa University, you acknowledge and agree that you have a continuing obligation to inform the University of

  • any formal disciplinary action for academic or non-academic reasons at any educational institution;
  • any legal charges and/or convictions (or foreign legal equivalents) that have not been expunged by a court;
  • and/or any behavior that causes injury to person(s) or property which results in some form of discipline or intervention.

 

You must provide updated information to the campus admissions committee prior to class attendance. At that time, the campus admissions committee will review the information provided and may consider whether to delay or rescind your admission to CU.

 

 

Behavioral/Disciplinary Disclosure


{{ errorMessage.text }}
{{ errorMessage.text }}

 

 

Explanation and Documentation


Please upload a document that contains a complete explanation (in English) of:

  • the disciplinary action, charges, conviction, or other behavior that caused injury to person(s) or property which resulted in some form of discipline or intervention;
  • the dates and court disposition (court ruling or result),
  • the location (city, state, and country),
  • the impact the incident(s) had on you, and
  • a statement granting your permission to officials at all institutions and agencies to release information needed by CU to substantiate statements made in your application or letter

 

Please attach your complete explanation to this application electronically. Acceptable formats are .pdf, .doc/.docx, and .txt files. (Maximum size 50MB)

Please note the campus admissions committee may request additional information from you and that additional time may be required to review the information you provide.

If you have questions about your application, you may contact the admissions office on the campus to which you are applying.

{{file}}

Application Affirmation

 

 

Application Certification

 

 

General Affirmation


I certify that I am the applicant and that all statements on this application are correct and complete, including a list of all schools attended.

 

I understand that any of the items listed below constitute grounds for immediate withdrawal of my application from further consideration and cancellation of my admission and/or registration.

  • Withholding pertinent information requested on this application.
  • Providing false or incomplete information.
  • Failure to disclose disciplinary action or criminal activity, as outlined in the "Criminal Activity Disclosure" section of this application.

 

I understand that providing false information could also impact the classification of tuition residency status for fee-paying purposes and scholarship eligibility.

{{ errorMessage.text }}

 

 

Criminal/Disciplinary Affirmation


I have provided a complete explanation describing my criminal or disciplinary history as described in this application and the instructions outlined in the "Criminal Activity Disclosure" section of this application. The explanation contains a statement granting my permission to officials at all institutions and agencies to release information needed by CU to substantiate statements I have made in my application and my explanation.
{{ errorMessage.text }}

 

 

Application Fee Refund Policy


Application fee payments are not refundable. By submitting this application, the applicant understands and agrees.
{{ errorMessage.text }}

 

 

My Electronic Signature


I provide my full legal name and today's date as my electronic signature for this application
{{ errorMessage.text }}

Sign Here
{{ errorMessage.text }}
{{ errorMessage.text }}

Application Fees and Submission

 
 

Application Fee


The application fee shown below covers all fees for applying to Captisa University.
{{ errorMessage.text }}
{{ errorMessage.text }}

Thank you! Your response has been submitted.

60% Complete
alert