APPLICATION FOR ADMISSION TO THE BACHELOR OF SCIENCE IN EDUCATION PROGRAM
Submit typed application and recommendations, in one packet, to 106 Bavaro Hall by February 15th.
1. Year/Semester of Entrance: ____________/_______________
2. Social Security Number:* ___________________________________
*Our request for disclosure of social security number is optional except when required by federal law for such matters as financial aid and work-study
assistance. This request is made to assist the University in tracking your credentials internally and providing you with a personal identification number
for use at the University of Virginia. This Request is made in accordance with Section 2-2-3803 of the Virginia Code and general Administrative
authority over University operators.
3. Name: ________________________________________ ________________________________________ __________
Last First, MI Suffix
4. Application for Admission to: (Please check one below)
Kinesiology with a concentration in:
Adapted Physical Education
5. Email: _____________________________________________ 9. Birthdate: _____/_____/_____ 10. Gender: ______
Yr Mo Day M/F
6. Permanent Mailing Address: ______________________________________________________________________________