IMSD Application

Pre-Application

Please fill in the form and click the Submit button. All fields are required.
KU Student Number: 7 digits
Name:

First		  
Middle		  
Last
Local Address:

Number and Street

City
State
Zip Code
Phone:
Email:
Are you a citizen of the United States?   Yes   No
Did you transfer to the University of Kansas from another institution?   Yes   No
If yes, please list the institution(s) attended previously:
Did you receive a degree from another institution?   Yes   No
If yes, list Degree:   and Major:
Current major(s); area(s) of concentration:
Current class: Freshman   Sophomore   Junior   Senior
Anticipated 
Graduation Date:

Month		  
Year
What are your career goals?
Are you first-generation college student?   Yes   No
Race or Ethnicity:
Please check all 
that apply.
American Indian or native Alaskan - Tribe(s):
Black (non-Hispanic)
Asian American
Pacific Islander
Latino(a) or Chicano(a) or Hispanic
White (non-Hispanic)
Other






The University of Kansas prohibits discrimination on the basis of race, color, ethnicity, religion, sex, national origin, age, ancestry, disability, status as a veteran, sexual orientation, marital status, parental status, gender identity, gender expression and genetic information in the University’s programs and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Director of the Office of Institutional Opportunity and Access, IOA@ku.edu, 1246 W. Campus Road, Room 153A, Lawrence, KS, 66045, (785)864-6414, 711 TTY.