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<BODY BGCOLOR="#FFFFFF" TEXT="#000000" LINK="#A50018" VLINK="#A50018" ALINK="#FFB400">
<FONT FACE="ARIAL,hELVETICA,MS SANS SERIF,SANS-SERIF">
<CENTER><img src="http://www.umsl.edu/admission/adintro.jpg">
<H2>Application for Admission</H2>
<p> Office of Admissions<BR>
University of Missouri-St. Louis<BR>
8001 Natural Bridge Rd<BR>
St. Louis, MO 63121
<P>
<table width = 400> <tr><td>
<hr>
<form action="/servlet/FormServlet" method="POST">
<input name="E_Mail" type="hidden" value="SiegelJ@msx.umsl.edu">
<input name="URLreturn" type="hidden" value="http://www.umsl.edu/admission/thankapp.htm">
<!-- Another way of providing a template to rewrite and return-->
<input name="Conditional" type="hidden" value="http://www.umsl.edu/admission/failapp.htm">
<!-- Anything that has a "name" beginning with the string "REQ" must be filled in.
This is really a legacy feature since one cannot specify a format for the string thatis returned.
JavaScript is a more appropriate tool to implement this requirement.
is
-->
<input type="hidden" name="from_address" value="complex_form@umsl.edu">
<input type="hidden" name="SMTPreturn" value="/accounts/faculty/siegel/public_html/FormsTalk/complexmail/complexmail_response.txt">
<OL>
<LI>
<H3>Please check one:</H3>
<table width=500 cellspacing=0 cellpadding=0 border=0>
<TR>
<TD width=450>
<input type="radio" name="application_type" value="NEW FRESHMAN">
First-Time Freshman<BR>
<input type="radio" name="application_type" value="RETURNING STUDENT">
Returning Student<BR>
<input type="radio" name="application_type" value="TRANSFER STUDENT">
Transfer Student<BR>
<input type="radio" name="application_type" value="NON-DEGREE SEEKING">
Non-Degree Seeking Student <EM>(financial aid may not be available)</EM><BR>
</td>
</tr>
</table>
<P>
<LI>
<H3>Background Information</H3>
<table width=500 cellspacing=0 cellpadding=0 border=0>
<tr>
<td width=450>First Name:</td>
<td>
<input name="REQfname" size="30">
</td>
</tr>
<tr>
<td width=450>Last Name:</td>
<td>
<input name="REQlname" size="30">
</td>
</tr>
</table>
<UL>
<LI>
<p>
</UL>
<LI>
<H3>High School Information:</H3>
<table width=500 cellspacing=0 cellpadding=0 border=0>
<tr>
<td width=450>Name of School: </td>
<td>
<input name="highschoolname" size=30>
</td>
</tr>
<tr>
<td width=450>City: </td>
<td>
<input name="highschoolcity" size=30>
</td>
</tr>
<tr>
<td width=450>State: </td>
<td>
<input name="highschoolst" size=30>
</td>
</tr>
<tr>
<td width=450>Dates of attendance:</td>
<td>
<input name="hsstart" size=10>
to:
<input name="hsend" size=10>
</td>
</tr>
<tr>
<td width=450>Graduation Date: </td>
<td>
<input name="hsgrad" size=30>
</td>
</tr>
<tr>
<td width=450>Have you earned the G.E.D. equivalent certificate?</td>
<td>
<input type="radio" name="ged" value="no" >
No
<input type="radio" name="ged" value="Yes">
Yes</td>
</tr>
<tr>
<td width=450>If yes, date and year: </td>
<td>
<input name="gedwhen" size=30>
</td>
</tr>
</table>
<P>
<P>
<LI>
<H3>Colleges and Universities Previously or Currently Attended:</H3>
<UL>
<LI>List the name and location of all colleges and universities
attended, dates of attendance, degrees earned or expected prior
to anticipated enrollment at UM-St. Louis. If there are none,
type the word "none" in first college name area.
<p>
</UL>
<P>
<table border=0>
<tr>
<th></th>
<th>Name<br>
of College</th>
<th> Location <br>
(City,State) </th>
<th> Dates of <br>
Attendance</th>
<th>Degrees<br>
Earned</th>
<th>Degree Dates</th>
</tr>
<tr>
<td>1.</td>
<td>
<input name="prevschool1" size="18">
</td>
<td>
<input name="prevlocation1" size="13">
</td>
<td>
<input name="prevdates1" size="10">
</td>
<td>
<input name="prevdeg1" size="10">
</td>
<td>
<input name="prevdegdates1" size="10">
</td>
</tr>
<tr>
<td>2.</td>
<td>
<input name="prevschool2" size="18">
</td>
<td>
<input name="prevlocation2" size="13">
</td>
<td>
<input name="prevdates2" size="10">
</td>
<td>
<input name="prevdeg2" size="10">
</td>
<td>
<input name="prevdegdates2" size="10">
</td>
</tr>
</table>
<p>
<LI>Approximate total semester hours completed:
<input name="hourscomplete" size="10">
</OL>
<H3><STRONG>IMPORTANT! PLEASE READ!</STRONG> </H3>
<UL>
<li>Please check over your entries to make sure they are all accurate
before submitting this application.
<P>
</UL>
<P>
<center>
<table>
<TR><TD><input type=submit value="Submit This Application"></td><td>
<input type=reset value="Clear Everything"></td></tr></table>
</center>
</form>
</td></tr></table>
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