Application For The Social Work (BASW) Online Degree Completion Program

 

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APPLICATION FOR THE SOCIAL WORK (BASW) ONLINE DEGREE COMPLETION PROGRAM

APPLICATION FOR THE SOCIAL WORK (BASW) ONLINE DEGREE COMPLETION PROGRAM

An application fee of $40 will be deferred until your first semester bill.

  • Date of Birth Date of Birth * / /
    Pick a date.
  • Name Name *
  • Would you like to add any alternate or former names (such as a maiden name)?
    Would you like to add any alternate or former names (such as a maiden name)?
  • Alternate/Former Name (1) Alternate/Former Name (1)
  • Alternate/Former Name (2) Alternate/Former Name (2)
  • Home Address Home Address *
  • Phone Phone * - -
  • Preferred Contact Method
    Preferred Contact Method
  • Are you a current or former Millersville student? *
    Are you a current or former Millersville student?
  • Previous Transfer Institution Information

    Please be sure to list all former institutions in order to avoid delaying your application.

  • Address of Institution Address of Institution
  • Associates, bachelor, master, certificate...

  • Did you graduate?
    Did you graduate?
  • Would you like to add a second Institution?
    Would you like to add a second Institution?
  • Address of Institution (2nd Institution) Address of Institution (2nd Institution)
  • Associates, bachelor, master, certificate...

  • Did you graduate? (2nd Institution)
    Did you graduate? (2nd Institution)
  • Would you like to add a third Institution?
    Would you like to add a third Institution?
  • Address of Institution (3rd Institution) Address of Institution (3rd Institution)
  • Associates, bachelor, master, certificate...

  • Did you graduate? (3rd Institution)
    Did you graduate? (3rd Institution)
  • Would you like to add a fourth Institution?
    Would you like to add a fourth Institution?
  • Address of Institution (4th Institution) Address of Institution (4th Institution)
  • Associates, bachelor, master, certificate...

  • Did you graduate? (4th Institution)
    Did you graduate? (4th Institution)
  • Would you like to add a fifth Institution?
    Would you like to add a fifth Institution?
  • Address of Institution (5th Institution) Address of Institution (5th Institution)
  • Associates, bachelor, master, certificate...

  • Did you graduate? (5th Institution)
    Did you graduate? (5th Institution)
  • High School Information

  • High School Address High School Address
  • Month & Year Only

  • Additional Information

  • Are you a PA Resident? *
    Are you a PA Resident?
  • Please note that our program is not available to residents of some states. If your residency is in a state other than Pennsylvania, we will follow up with you when processing your application to determine your eligibility. Please feel free to contact us at OnlinePrograms@millersville.edu with any related questions or concerns.

  • Are you a U.S. Citizen? *
    Are you a U.S. Citizen?
  • If you answered NO to the question above are you a resident alien?
    If you answered NO to the question above are you a resident alien?
  • Have you ever been convicted of a criminal offense?
    Have you ever been convicted of a criminal offense?
  • Supplemental Information

    Completion of this section is voluntary. The purpose of this information is to submit reports to governmental compliance agencies and for university administrative data collections. This information will not affect the admission decision.

  • Gender
    Gender
  • Verification of information

  • Consent for the collection and processing of sensitive or personal data
    From the European Union for admission and enrollment purposes


    1) Pursuant to the European Union General Data Protection Regulation (EU GDPR), the Pennsylvania State System of Higher Education and its member universities, including Millersville University of Pennsylvania (“University”), in its capacity as a data controller under the EU GDPR, must obtain explicit, affirmative consent before it can collect or process any sensitive or personal data for a lawful basis including for admission and enrollment purposes.

    2) Sensitive data includes data revealing racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic or biometric data; health data; or data concerning a person’s sex life or sexual orientation.

    3) Any sensitive or personal data that is collected will be for the sole purpose of application for admission to the University that is sent from the EU and is necessary for that purpose or for any purpose permitting the use of sensitive or personal data under applicable law or to meet other compliance obligations of the University.

    4) I understand that any sensitive or personal data that is collected will also be used to report serious illness, injury, or other health or emergency situations involving me, as well as to address or report discrimination, harassment, sexual or gender-based misconduct and criminal behavior which may be committed by or against me or otherwise involve me, on or off campus, to appropriate authorities including staff, faculty, and administrators of the University or appropriate legal or governmental authorities under applicable policies of the Pennsylvania State System of Higher Education or the University (including but not limited to applicable codes of conduct) and applicable laws (including but not limited to Title IX and the Clery Act).

    5) I understand that refusal to consent to the use of sensitive or personal data, and the transfer of sensitive or personal data overseas, for the purpose outlined in this notice may make it impossible for the University to carry out necessary activities, and may preclude the University’s ability to provide requested services.

    6) I understand I have the right to withdraw consent to the collection and processing of sensitive or personal data and to do so, I must contact the Online Programs office at (717) 871-7200 or OnlinePrograms@millersville.edu. I also understand that the complete deletion of data will not be feasible in all situations to ensure the University’s ability to comply with regulatory requirements.

  • Terms *
    Terms