Dual Admission Intent Form



NOTE: This Dual Admission intent form is NOT the same as the application for admission to Millersville University.
 ______________________________________________________________________
Personal Info
Birthdate
Birthdate
May we text you?
May we text you?
Mailing Address
Mailing Address
Are you Hispanic or Latino?
Are you Hispanic or Latino?
Are you a Pennsylvania resident who has lived in the state for more than 12 months?
Are you a Pennsylvania resident who has lived in the state for more than 12 months?
 ______________________________________________________________________
Dual Admissions Info
 ______________________________________________________________________
Community College Info
Start Date
Start Date
Expected Graduation Date
Expected Graduation Date
 ______________________________________________________________________
Signature
Students may apply for admission under the Dual Admission Program as early as their senior year of high school but no later than the completion of 30 college-level credits in a transfer program offered through their community college(s). 

Students enrolled in the Dual Admission Program must maintain continuous enrollment at their current community college, earn the associates degree and meet all Millersville admissions requirements, including grade point average for their intended major.

Please inform your community college and Millersville of any changes in your plans and update relevant personal information.  If you attend another college/ university in addition to your current community college to complete college credits, you must request an official transcript(s) to be sent directly to Millersville.

I authorize my current community college, which I have indicated on this form, and Millersville to exchange necessary information regarding my matriculation and course work, including academic transcripts, at both institutions to facilitate the transfer from my current community college to Millersville and to provide the information needed to evaluate the program.  Such information will be reported in summary form so that no student will be identified individually.

Millersville University of Pennsylvania, in compliance with federal and state laws and university policy, provides equal educational, employment, and economic opportunities for all persons without regard to race, gender, age, ethnicity, national origin, religion, sexual orientation, or marital, veteran, or disability status. Direct requests for disability accommodations and other inquiries should be made to the Office of Learning Services, Millersville University PO Box 1002 Millersville, PA 17551-0302, 717-871-5554
Today's Date
Today's Date