Undergraduate Application for Exchange Programs

Note: This is not an application for admission to a degree program. If you wish to be admitted to a degree program, please visit our website to complete an application online.

About You

First Name

Middle Name

Last Name

Other names that may appear on educational records

Email Address

Home Telephone Number

Mobile Telephone Number

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Country

Street

City

Region

Postal Code

Birthdate

Sex

Gender Identity

If you would like the opportunity, we invite you to share more about your gender identity.

Preferred Pronouns

Other Preferred Pronouns

Are you a U.S Citizen or Permanent Resident?

Yes

No

If you are an International Student, please provide your Country of Citizenship

Place of Birth

City of Birth

Colleges and universities are asked by many groups, including the federal government, accrediting associations, college guides, and newspapers, to describe the ethnic/racial backgrounds of their students and employees. In order to respond to these requests, we ask you to answer the following two questions.
View Definitions

Are you Hispanic or Latino?

Yes

No

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Your Plans

Entry term

Undergraduate Nondegree Courses (please select from list)

Nondegree area of study:

Are you applying to a nondegree or certificate program as a Freshman (no college credits) or a Transfer (college credits)?

Please select the application type

Time Status

Housing Preference

Please share the course you would like to take or areas of academic interest

Education

Secondary School (Type in high school or GED and select from list)

Date of Graduation (i.e MM/YYYY)

Date From (i.e MM/YYYY)

Date To (i.e MM/YYYY)

Please list all colleges or universities attended.

College (Type name and select from list)

Date of Graduation (i.e MM/YYYY)

Date From (i.e MM/YYYY)

Date To (i.e MM/YYYY)

Degree Awarded

College (Type name and select from list)

Date of Graduation (i.e MM/YYYY)

Date From (i.e MM/YYYY)

Date To (i.e MM/YYYY)

Degree Awarded

College (Type name and select from list)

Date of Graduation (i.e MM/YYYY)

Date From (i.e MM/YYYY)

Date To (i.e MM/YYYY)

Degree Awarded

Additional Information

Have you ever been convicted of a felony (without the record being sealed or expunged)?

Yes

No

If you answered "Yes" please provide an explanation below.

I, the undersigned, acknowledge that by signing this application form, I am hereby responsible for any and all tuition, fees, and other charges incurred during my enrollment at Western New England University. Furthermore, I understand that any and all payment terms must be satisfied before the beginning of each academic session, and that failure to do so may prevent me from being able to register at Western New England University for future sessions. I also understand that finance charges will accrue on any and all unpaid balances. Lastly, I understand that I will be financially responsible for all costs related to collection of any and all unpaid balances, including but not limited to attorney fees, collection costs, and further interest. I understand the application fee is not refundable for any reason.

I certify the information contained within is complete and correct to the best of my knowledge, and that I am the original author of any information that is directly requested of me. I understand that my acceptance and matriculation may be canceled if any information in support of my application is found to be false.

In place of your signature, please type your full legal name:

Submitted Date