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Youth Options Program Application

We are pleased that you have decided to apply for admission to take courses at Carroll University. Qualified secondary school students are eligible to take 11 credits or less during a single semester at Carroll. Our admission criteria specify that students with cumulative grade point averages of 3.0 are eligible for acceptance.

General Information
*Last name:
*First name:
Middle name:
Male Female
Permanent home address:
If your mailing address is different from above, please enter the address you want us to use.
Permanent Phone:
Mailing phone:
Date of Birth:
E-mail address:
Are you a U.S. citizen?
Yes No, (if no)
Citizen of:
Type of visa:
Are you a legal resident of Wisconsin?
Yes No, (if no)
Which state:
Date you plan to enroll:
Enrollment year:
Family Information
Father's full name
Is he living?
Yes No
Father's occupation:
Place of employment
Mother's full name
Is she living?
Yes No
Mother's occupation:
Place of employment
Academic Honors
Please describe any scholastic distinctions or honors you have won since the ninth grade.
Extracurricular and Personal Activities
Please list your principal extracurricular, community and family activities and hobbies.
Additional Information
High School
School district
Date of high school graduation
Please list the courses you plan to take at Carroll University
Intended college major
Guidance counselor name
Phone number
E-mail address
All Applicants Must Complete This Section
Have you ever been dismissed from school for disciplinary reasons?
Yes No
Have you ever been convicted of any offense other than a minor traffic violation?

Yes No, if yes, please explain

Carroll University is committed to maintaining a safe learning environment for all members of the college community. As such, the college requires all applicants who are under current indictment, who have been convicted of a crime (other than a routine traffic offense or a juvenile proceeding), or who have been dismissed from another academic institution for disciplinary reasons, to disclose this information as a mandatory step in the application process. A previous conviction, current indictment or disciplinary dismissal does not automatically bar one’s admission to the college.

I understand that withholding pertinent information on this application, or giving false information, will: (a) make me ineligible for admission to Carroll University; (b) cancel my registration if admission has occurred; and/or (c) subject me to dismissal from the college if I have already enrolled.

Carroll University does not discriminate on the basis of race, sex, creed or religion, age, color, national or ethnic origin or physical handicap in the administration of its educational policies, admissions policies or scholarship and loan programs.

Youth Options application (PDF)

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