This Application Is for University of Scranton Employees Only

This application is for University of Scranton employees only.

School Year Applying for Tuition Exchange: 2018 – 2019

Student Royal ID# (Check with HR if unknown):

Student First Name:

Student Last Name:

Student Telephone:

Student SSN (at least last four #s):

Student Email:

Address:

City, State Zip:

Student Birthday (MM/DD/YYYY):

Parent/Guardian Royal ID#:

Parent/Guardian Name:

Parent/Guardian Email:

Start Date of Employment for Parent/Guardian:

Parent Employment Category: (Faculty, Staff)

Class for School Year above: (Freshmen, Sophomore, Junior, Senior)

Application Status: (Applying for Admission, Approved for Admission, Currently Enrolled)

Schools for the different programs may be found: Tuition Exchange Schools CIC Schools FACHEX Schools Applied School's Full Name with State TEP CIC FACHEX (Y/N) Sample: University of Scranton - PA x x x Y