Rockford University

Application for Admission

Student Information

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Your social security number is sensitive personal information which may be used to complete and process your application. We have established a secure Internet connection for your submission, and your social security number will be encrypted while in transit, but we cannot guarantee protection of your social security number from disclosure. By continuing with submission of your application and voluntarily disclosing your social security number, you assume the inherent risks of doing so and consent to transmission of your social security number over the Internet.

Address Information

Permanent Address

Mailing Address

Personal Information

Citizenship Information

Demographic Information (Optional)
If you wish to be identified with a particular ethnic group, please select the choice that most accurately describes your heritage. No information you provide will be used in a discriminatory manner.

Family Information

Parent 1

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Parent 1 Permanent Address

Parent 2

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Parent 2 Permanent Address


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Guardian Permanent Address

Legacy Information

Do you know anyone else that attended Rockford University? (optional)
Family Member 1

Family Member 2

Family Member 3

Family Member 4


Your Enrollment Plans

Area of Academic Interest
(If you're not sure, that's OK; just select "Undecided.")

High School Information

Most Recent High School

Previous High School 1

Previous High School 2

Your cumulative GPA is the grade point average calculated based on all of your completed high school courses. 

Academic Information


College/University 2

College/University 3

College/University 4

College/University 5

College/University Information
Please enter the country, state, city and name of all colleges and universities attended, starting with the most recent.

College/University 2 Information

College/University 3 Information

College/University 4 Information

College/University 5 Information

Additional Information

SAT and ACT Test Scores
Please provide information about your SAT or ACT scores (only one is required).

If you are transferring with fewer than 12 credit hours, please make sure we receive your official test scores.

ACT Test Details

SAT Test Details

Guidance Counselor Information
Please provide the following information about your high school guidance counselor. Once you submit your application, an email will be sent to your counselor alerting him or her to the steps required to help you complete your application

Activities and Interests

Activities & Honors
Please list you high school activities (sports, service projects, clubs, special interests, leadership positions, etc.) and honors you have received.

Activities at Rockford



Please enter your full name in the signature box, verifying that you have completed the application.