Pittsburgh Admission Data Form PDF Details

Are you thinking of studying at a university in Pittsburgh? If so, then you’ve come to the right place. This blog post will provide you with information about what it takes to apply for admission at many universities within the city of Pittsburgh. We will review all that is needed to successfully submit your application, discuss the various timelines and deadlines associated with each school's admissions timeline, and also outline any specific document requirements or paperwork that needs to be included in order gain entrance into one of these great schools. So whether you are just starting the college search process or getting ready to send in applications soon, this blog post should help give insight into what submitting an effective application looks like for a university based in Pittsburgh!

QuestionAnswer
Form NamePittsburgh Admission Data Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names20736 upj admission data form

Form Preview Example

ADMISSION DATA FORM

In order to complete the admission process, both the Admission Data Form and Enrollment Deposit Form, including your deposit, must be submitted.

NAME (Last, First, M.I.)

SOCIAL SECURITY NUMBER

PERMANENT ADDRESS (LINE 1)

PERMANENT ADDRESS (LINE 2)

 

 

CITY

 

STATE

ZIP CODE

 

 

 

 

 

 

AREA CODE, TELEPHONE NUMBER

AREA CODE, CELL PHONE NUMBER

PARENT’S E-MAIL ADDRESS

 

(

)

(

)

 

 

 

 

 

 

 

 

 

 

 

 

FOREIGN ADDRESS (Country, Zip, City, Province)

DATE OF BIRTH (mm/dd/yyyy)

/ /

SEX

FEMALEMALE

PLEASE ANSWER ALL QUESTIONS

Where are you planning to reside?

 

ON CAMPUS (1)

COMMUTE (2)

OFF CAMPUS (3)

 

 

 

 

 

 

What is your citizenship status?

U.S. Citizen

U.S. Immigrant/

 

Refugee

Nonimmigrant

Permanent Resident Alien

 

 

 

 

Are you a resident of Pennsylvania?

 

 

 

 

No, not a PA Resident

If yes, for more than one year or less than one year?

 

 

 

Yes, less than one year

(Count back from the beginning of the term for which you are enrolling.)

 

 

 

Yes, more than one year

Is your father a resident of Pennsylvania?

If yes, for more than one year or less than one year?

(Count back from the beginning of the term for which you are enrolling.)

No, not a PA Resident

Yes, less than one year

Yes, more than one year

Is your mother a resident of Pennsylvania?

If yes, for more than one year or less than one year?

(Count back from the beginning of the term for which you are enrolling.)

No, not a PA Resident

Yes, less than one year

Yes, more than one year

Is your guardian a resident of Pennsylvania?

If yes, for more than one year or less than one year?

(Count back from the beginning of the term for which you are enrolling.)

No, not a PA Resident

Yes, less than one year

Yes, more than one year

I recorded the above. The information given is true and correct. I understand that falsification of any data may result in dismissal. I authorize any employer, educational institution, or agency to release such data as is required by the University to verify any of the above information. By signing below, I also authorize the University of Pittsburgh to request and, my high school and/or testing agencies to release, any academic information or college entrance test results needed to make my admissions file complete.

Date

Student’s Signature

DO NOT WRITE IN SHADED AREA.

ENROLLMENT DEPOSIT FORM

STUDENT’S NAME (Last, First, M.I.)

 

 

 

 

 

 

 

 

SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE RECEIVED (mm/dd/yy)

/

/

DEPARTMENT NAME

UNIVERSITY TELEPHONE EXT.

 

 

CREDIT CARD INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

Office of Admissions

814-269-7050

 

 

 

See instructions on back.

 

ENROLLMENT DEPOSIT

 

AMOUNT

DEPOSIT FOR

 

 

MasterCard

 

 

 

 

Visa

A

(NONREFUNDABLE/NONTRANSFERABLE)

 

TERM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CREDIT CARD NUMBER

 

 

 

 

 

 

 

 

 

TOTAL AMOUNT RECEIVED IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$100.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check

 

MC

 

PRINT NAME AS SHOWN ON CARD

 

 

 

 

 

 

 

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT CHARGED

EXPIRATION DATE (mm/yy)

 

Money Order

 

Visa

$

 

 

 

 

 

$

 

 

 

 

 

 

D

 

 

 

 

 

 

 

 

E

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTRUCTIONS

ACheck MasterCard or Visa.

BPrint you credit card number in the appropriate box.

CPrint cardholder’s name.

DEnter the amount to be charged.

EEnter card’s expiration date.

REMEMBER

Your bank credit card limit cannot be exceeded. If you are in doubt regarding the limit, contact your bank before completing this form.

Before the University can accept your charge, it must receive authorization from the MasterCard or Visa authorization center. If this center declines to accept your charge, we will so indicate on the deposit receipt and will return it and any other documents to you.

If your charge is declined, contact your bank for the reason. The authorization center will not give the University the reason for its refusal to authorize the charge.

The University of Pittsburgh is an affirmative action, equal opportunity institution.

UMC28084-0707