Early Enrollment Form

West Virginia State University is excited you have enrolled and participated in our Early Enrollment Program. Thank you for expressing interest in West Virginia State University. We would like your consent to complete an application for the fall 2023 semester as a first-time freshman within one of WVSU’s bachelor degree programs.

To complete this process, please complete the following information:

Full Name:

Desired Major:

Date of Birth:

Has there been any changes for information we have on file? (I.e. name, address, directory information). If so, please check the appropriate box and provide the new information in the space below.

Information on File:

Name
Address
Other

Updated Information:

By electronically signing this document, I fully understand that my information will be used to apply to West Virginia State University for the fall 2023 semester as a first-time freshman, with full-time student status. Please sign your full name, and enter the date below.

Electronic Signature:

Date:

Security code:

Enter security code:

Early Enrollment Form

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