STILLMAN COLLEGE

Office of Admissions
Post Office Box 1430
Tuscaloosa, Alabama 35403-9990
(800)841-5722

STILLMAN MANAGEMENT INSTITUTE

Admissions Application

Non-Refundable $50.00 Applicant Fee
PERSONAL PROFILE
Title: Mr.     Mrs.     Ms. Gender:  Male     Female
Ethnic Background: (optional)
Name:
Social Security Number: --
Address:
City:
State:
Zip Code:
Home Number: ()-
Email Address:
Date of Birth
Place of Birth
COLLEGE PLANS
Intended Semester of Enrollment Year:
Incoming Student Certification
Will you be applying for Financial Aid?
ACADEMIC HISTORY
List all Colleges/Universities attended (including Stillman) Official Transcripts from each institution must be forwarded to the Office of Admission.

Name of School

City/State

Dates Attended
1.
2.
3.
GENERAL INFORMATION
How did you hear about the SMI Program?
Highest Education Level Degree Received
PRESENT EMPLOYER
Company Name:
Address:
City/State:
Zip:
Dates Employed:
Job Title:
STUDENT PLEDGE AND DECLARATION
I, the undersigned have read or shall read the college bulletin and all materials relating to student conduct.  If admitted, I will be governed by all regulations of the college.  Furthermore, I will uphold the good name of the college religiously, academically, culturally, and socially.  I hereby declare that the information supplied on this application is true and correct to the best of my knowledge, and I will notify the office of Enrollment Management immediately of any changes or additions to the information provided.  I understand that any omissions, falsifications, or misrepresentation of the information provided may result in denial of admission to or dismissal from Stillman College.

Press the button below to SUBMIT your application.  By doing so, you are agreeing to the conditions and terms stated above.