Adelphi Excellence Application

Personal Information

First/Given Name

Middle Name

Last/Family Name

Preferred Name

Home Phone Number

Cell Phone Number

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International Phone Number (if applicable)

Email Address

Date of Birth

Sex Assigned at Birth

Male Female

Federal guidelines mandate that we collect data on the legal sex of all applicants. Please report the sex currently listed on your birth certificate.

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

What is your preferred pronoun?

Country of Birth

Your Address

Permanent Address

Address

Apt. #

City

ZIP/Postal Code

Country

Is your mailing address the same as your permanent address?

Yes No

Mailing Address

Address

Apt. #

City

ZIP/Postal Code

Country

Mailing Address Effective Until

Your Family

To whom should we send information?

One Parent/Guardian Both Parents/Guardians

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Address

Apt. #

City

State/Province

ZIP/Postal Code

Country

Do you have any siblings also applying for undergraduate admission to Adelphi University this year?

Yes No

Alumni Relationships

If you have any relatives who are alumni of Adelphi University, please list their names and relationships to you below.

First Name

Last Name

Maiden Name (if applicable)

Relationship to You

Graduation Year

+ Add Another Alumnus/a

Ethnicity (Optional)

If you wish to be identified with a particular ethnic group, please select the choice that most accurately describes your heritage. No information you provide will be used in a discriminatory manner.

Are you Hispanic or Latino?

Yes No

Select one or more of the following races:

Welcome to your Adelphi Excellence Application!

Personal Information

Your Address

Permanent Address

Mailing Address

Your Family

Parent 1/Guardian 1

Parent 2/Guardian 2

Alumni Relationships

Citizenship

Ethnicity (Optional)