2010-11 First-year Application For Spring 2011 or Fall 2011 Enrollment
APPLIC ANT Dewey John Legal Name ___________________________________________________________________________________________________________________ Last/Family/Sur (Enter name exactly as it appears on official documents.)
First/Given
Middle (complete)
Jr., etc.
Preferred name, if not first name (choose only one) ______________________
Former last name(s), if any _______________________________________
10/20/1859 Birth Date ____________________________________________________ Female Male
US Social Security Number, if any ___________________________________
mm/dd/yyyy
Optional, unless applying for US Federal financial aid with the FAFSA form
Preferred Telephone Home Cell Home (_______) __________________________________ Cell (_______) __________________________________ Area/Country/City Code
Area/Country/City Code
E-mail Address ________________________________________________
IM Address ____________________________________________________
Permanent home address __________________________________________________________________________________________________________ Number & Street
Apartment #
____________________________________________________________________________________________________________________________ City/Town
County or Parish
State/Province
Country
If different from above, please give your current mailing address for all admission correspondence.
ZIP/Postal Code
(from ___________ to ___________) (mm/dd/yyyy)
(mm/dd/yyyy)
Current mailing address __________________________________________________________________________________________________________ Number & Street
Apartment #
____________________________________________________________________________________________________________________________ City/Town
County or Parish
State/Province
Country
ZIP/Postal Code
If your current mailing address is a boarding school, include name of school here: ____________________________________________________________ _____
FUTURE PLANS Your answers to these questions will vary for different colleges. If the online system did not ask you to answer some of the questions you see in this section, this college chose not to ask that question of its applicants.
Johns Hopkins University College ________________________________________________________
Deadline ______________________________________________________ mm/dd/yyyy
Entry Term: Fall (Jul-Dec)
Spring (Jan-Jun)
Do you intend to apply for need-based financial aid?
Yes No
Decision Plan___________________________________________________ Philosophy Academic Interests _____________________________________________
Do you intend to apply for merit-based scholarships?
Psychology ____________________________________________________________
Do you intend to enroll in a degree program your first year?
Yes No Yes No Yes No
Philosophy ____________________________________________________________
No Do you intend to live in college housing? ______________________________
Professor Career Interest _________________________________________________
M.D. What is the highest degree you intend to earn? _________________________
Do you intend to be a full-time student?
DEMOGRAPHICS Citizen Citizenship Status ______________________________________________
1. Are you Hispanic/Latino?
N/A Non-US Citizenship ______________________________________________
Yes, Hispanic or Latino (including Spain) No
_____________________________________________________________ _____________________________________________________________ 52 Years lived in the US? ____________________________________________ Vermont United States Burlington Birthplace ________________________________________________________ City/Town
State/Province
Country
_________________________________________________________________________
2. Regardless of your answer to the prior question, please indicate how you identify yourself. (Check all that apply.) American Indian or Alaska Native (including all Original Peoples of the Americas) Are you Enrolled? Yes No If yes, please enter Tribal Enrollment Number________________ _________________________________________________________________________
English First Language _________________________________________________ English Primary language spoken at home _____________________________________
Asian (including Indian subcontinent and Philippines)
Conversational French Are you proficient in any other languages? _______________________________ from my Childhood _________________________________________________________________
Black or African American (including Africa and Caribbean)
_________________________________________________________________________
_________________________________________________________________________
Optional The items with a gray background are optional. No information you provide will be used in a discriminatory manner. Twice Married, Married to Alice Chipman Marital Status ____________________________________________________ Christian- Protestant Religious Preference _______________________________________________ US Armed Services veteran? Yes No ©
2010 The Common Application, Inc.
Native Hawaiian or Other Pacific Islander (Original Peoples) _________________________________________________________________________
White (including Middle Eastern) _________________________________________________________________________
AP-1 / 2010-11