Alcorn State University

Name of Applicant ___________________________________ 

Date of Birth _________________ U.S. Social Security Number ________________ 

Please provide information about yourself, your aims and plans for the future, reasons for wanting to study at Alcorn State University, and any other information that you believe may help us to evaluate your application. Use additional pages if necessary. 

I certify that all the information provided by me in this form and application for undergraduate admission (including any parts submitted electronically) is correct and accurate to the best of my knowledge. If admitted to Alcorn State University, I promise to abide by its rules and regulations, to make the proper use of the educational advantages offered and to see that bills are paid promptly. In signing, I allow Alcorn State University to fully evaluate my application for undergraduate admission.

Signature_______________________________________ Date ________________

Please mail completed personal statement to:

 
Director of Admissions
1000 ASU Drive #300
Alcorn State University
Alcorn State, Mississippi 39096 

For assistance, telephone: (601) 877-6147 or (601) 877-6148

 For assistance with A.S. Nursing or B.S. Nursing, telephone:
(601) 877-6550 or (601) 442-3901