Application Correction Form No SSO

* = required field

Some content may be updated based on selection

Office of Admissions

Application Correction Form

First Name:

Last Name:

Email Address:

Student Date of Birth:

This form is used only to modify an active application student type or current admission application term.

This form will not be processed if there is no existing application on file for the term selected or be used independently to apply for admission or if a student did not attend "No Show Term" for a previous inactive application term.

Student Information

Admit Type
Select the appropriate application term and type.

Change existing application term?

Yes

Term

Application Type

Application Type Description

Freshman

First time to attend any college after graduation from high school or earning a GED

Transfer

Attended a college other than Jefferson State

Transient

Enrolled at another college taking courses at Jefferson State to transfer back to your home institution.

Returning

Returning to Jefferson State after a break in enrollment of 12 months or longer

High School: If you did not provide a high school on your application, please enter high school information below.

High School Name:

City:

State:

Students are responsible for knowing the policies, procedures, and deadlines outlined in the Jefferson State Class Schedule and the Jefferson State Catalog & Student Handbook. By signing this form, I acknowledge that I have already submitted an admission application and authorize Jefferson State to modify the application. I certify that all information provided is accurate to the best of my knowledge. I understand that falsification of information in this application could result in dismissal or other disciplinary action.

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