Undergraduate Application for Admission
About
Please note that this form can not be processed without a payment on file.
Have you filled out a payment option form?
Required fields are marked with an *
Biograph
*Social Security Number
*Student Name
Maiden Name
*Street
*City
*State
*Zip
*Home Phone
Cell Phone
Work Phone
*E-mail Address
*Date of Birth
*Place of Birth
*Country of Citizenship
Please note: If you are not a US citizen, please forward a copy of your Visa or permanent residency status to the admissions office.
Government Statistics
Ethnic Origin: Gender:
Degree Programs
Please indicate which degree you will be pursuing: 
Primary Class Location: 
Previous Education
Please list the name, city and state of the high school from which you received your diploma or GED.
If you had a different name when you received it please list it here:
The State of Indiana requires us to have on file an official copy of every student's high school and college transcripts.
Have you requested that transcripts be sent to Indiana Tech?
Please list the colleges and universities you have attended as a full-time or part-time student, your name while attending if different, and the year of attendance.
Are you submitting CLEP/DANTES/USAF examinations for credit?
Professional Work Experience (Required only for the Accelerated Degree Program)
Prepare a history of your work experience. Start with your current or most recent employer and work backwards until you have accounted for a minimum of three years of full-time work experience. Admission to the Accelerated Degree Program requires the student to be at least 23 years of age.

Please enter the employer's name, street address, city, state, zip code, and telephone number:

Please type your job title, your employment dates, your job duties, and your accomplishments:

Please type the employer's name, street address, city, state, zip code, and telephone number:

Please type your job title, your employment dates, your job duties, and your accomplishments:

Please type the employer's name, street address, city, state, zip code, and telephone number:

Please type your job title, your employment dates, your job duties, and your accomplishments:
Financial Information
While it is the ultimate responsibility of each student to finance his or her education, Indiana Tech works with third parties to try and aid students in their quest for financial assistance. Please indicate which sources of financial aid you will be utilizing (if any), so that we may better assist you:

Please put check any of the following options that apply:
Employer Tuition Assistance
Veterans/Military benefits
Job Works
Government Student Aid Program
Student Loans
Other
None

If you are in need of financial aid, you may want to contact the Financial Aid office to obtain a Free Application for Federal Student Aid (FAFSA). This is required for all governmental aid and student loan programs. For more information about various aid programs, contact the Financial Aid Office at Indiana Tech at (800) 422-5561.
Verification
Payment by Credit Card:
Indiana Tech accepts MasterCard, Visa, Discover and American Express. If you are paying the $25 application fee by credit card, please complete the following section:
Please check the appropriate bank card:
Card Number
ex 6011-xxxx-xxxx-xxxx
Exp Date
ex: 10/02
Amount Name on card
$25
Indiana Tech admits students without regard to race, color, national or ethnic origin, or disability to all rights, privileges, programs, and activities generally accorded to or made available to students at the school. Indiana Tech does not discriminate on the basis of race, color, national or ethnic origin, or disability in administration of its educational policies, admissions policies, scholarship, loan programs and athletic and other school administered programs. Indiana Tech will make reasonable accommodations for qualified individuals with a disability so that such individuals can enjoy the same access to services, programs or activities as other non-disabled individuals.

Student Initials*