Coppin State University
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Tuesday January 6, 2009
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Admissions Office

If you are interested in attending Coppin State University, please tell us more about yourself through the survey below. Items with an asterisk (*) are required.

Mr. Ms.
* First Name 
* Last Name 
* Street 
* City 
* State 
* Zip 
Home Phone  () -
E-mail 
School or College 
Grad Year 

* 1. My present interest in CSU is:  
   Very strong  Somewhat strong  Uncertain  No longer interested

To select/deselect multiple fields:

-PC Users - Hold down the CTRL key while selecting
-Mac Users - Hold down the COMMAND key while selecting

Only the first three selected fields will be considered
* 2. I am interested in the following major areas:
Select up to 3


3. My college extracurricular interest include:
Select up to 3


4. I am interested in participating in the following intercollegiate athletics:
Select up to 3


* 5. I plan to visit the university. 
   Yes No

* 6. I would like an admission interview if a representative is in my area: 
   Yes No

* 7. I would attend a student/parent information session about admissions and student life in my area: 
   Yes No

* 8. Financing my college education is: 
   A major concern  Of some concern  Not a concern

* 9. I would like to speak with a financial aid counselor about paying for college: 
   Yes No

*10. I will apply for need-based financial aid (FAFSA): 
   Yes No  Apply online at www.fafsa.ed.gov

11. Please complete (if known): 
Class rank of:  Out of
* H.S. G.P.A.:  Out of 4.0
ACT Composite: 
SAT Verbal: 
SAT Math: 
Transfer Credits: 

12. My specific college needs/questions/concerns include: 
   

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2500 West North Avenue  ·  Baltimore, MD 21216-3698
Local: (410) 951-3000     Toll Free: (800) 635-3674
Email webmaster@coppin.edu
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