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This form is for students enrolled in the Community College System of New Hampshire who wish to transfer to the University of New Hampshire, Plymouth State University, Keene State College, or Granite State College. There is no application fee.

Are you a U.S. citizen?

YesNo

If no, do you have a permanent U.S. resident status card or a visa?

YesNo

If yes, how long have you resided in the U.S.?

<i>Please provide confirmation of your status by attaching a copy of your permanent resident card or visa documents. </i>

Are you Hispanic/Latino? (Optional)

YesNo

List your native language if other than English:

Regardless of your answer to the above question, please indicate how you identify yourself. (Optional)

Are you NH resident: You must have been a permanent, full time resident of the State of New Hampshire for a minimum of 12 months immediately prior to the first day of the semester for which you are applying in order to qualify for in-state tuition. Proof of residency will be required. All other residency restrictions as outlined by the USNH Board of Trustees will apply.

YesNo

Has either parent completed a bachelor's or graduate degree?

YesNo

Military Status (check all that apply)

If you have been discharged, a copy of your military form DD-214 indicating the nature of your discharge will be required.

Semester/Term For Which You Are Applying (Select One Only):

Intended Start Date (Year Only)

Full Time/Part Time:

Please indicate your intended major at Granite State College

View GSC's privacy policy then check the box to provide your consent to the terms and conditions.

Yes, I consent

View GSC's Student Financial Responsibility Agreement then check the box to provide your consent to the terms and conditions.

Yes, I consent

Please indicate your second choice major at Granite State College (Optional)

Please indicate your intended major at Keene State College

Please indicate your second choice major at Keene State College (Optional)

Please indicate your intended major at Plymouth State University

Please indicate your intended major at the University of New Hampshire (Durham)

Please indicate your second choice major at the University of New Hampshire (Durham) (Optional)

Please indicate your intended major at the University of New Hampshire (Manchester)

Please indicate your second choice major at the University of New Hampshire (Manchester) (Optional)

High School Attended:

High School

City/State

Ex.: "2015-2019" or "12-16."

Dates Attended

Ex.: "June 2019" or "06/2019"

Graduation Date

University /College(s) Attended:

Name of University/ College

City/State

Ex.: "2015-2019" or "12-16."

Dates Attended

Ex.: "June 2019" or "06/2019"

Graduation Date

If you are currently enrolled in coursework, please list your classes below:

I am not currently enrolled in coursework

Course Number

Course Title

Department

Semester

College/University

Credit

Have you ever been judged guilty or convicted of a misdemeanor, felony or other crime?*
(Note: You are not required to answer "yes" or provide an explanation if the criminal judgment or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise by a court to be kept confidential.)

YesNo

Please attach a separate document that gives the approximated date of the incident (s), explains the circumstances, and reflects on what you have learned from the experience. Please note: court documents may be required.

Have you ever been suspended, placed on probation, or dismissed from any college or university for any academic or disciplinary reasons or incurred other formal disciplinary action?*

YesNo

Please attach a separate document that gives the approximated date of the incident (s), explains the circumstances, and reflects on what you have learned from the experience.

*Any changes in these conditions will require you to notify the Office of Admissions within 14 days.

ALL Applicants: I have completed this form accurately and thoroughly. By signing below, I authorize my Community College and the University System of New Hampshire institution(s) to which I am applying to share my educational records and transcripts to expedite the transfer process and award any degrees or certificates earned.

Full Name of Applicant

Date

Document Upload

Please use this section to upload any additional necessary documentation

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