NAME(Required) First Middle Last Phone(Required)Email(Required) MAILING ADDRESS(Required) City, State, ZipCOUNTRY(Required) DOB(Required) MM slash DD slash YYYY SEX CITIZENSHIP RACE HIGH SCHOOL(Required) GRAD YEAR(Required) LAST COLLEGE ATTENDED, IF APPICABLE MAJOR FALL/ SPRING FRESHMAN / RE-ADMIT / TRANSFER INT? Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the equivalent) forward, related to behavioral misconduct that resulted in your long-term suspension (more than 10 days)? Yes No Excluding traffic infractions, have you ever been found guilty or convicted of a misdemeanor, felony, or other crime (including special or general court martial)? [Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.] Yes No Do you have any criminal charges pending against you? Yes No Excluding traffic violations, have you ever entered a plea of no contest or nolo contendere, or an Alford plea, to a misdemeanor, felony, or other criminal charge; or received a deferred prosecution or prayer for judgment continued for such a charge; or otherwise accepted responsibility for such a crime? Yes No Are you currently, or have you ever been, trespassed/banned from Livingstone College property? Yes No Do you have any pending disciplinary or behavioral issues with a prior institution that have yet to be resolved, or did you withdraw from a prior institution while under investigation for disciplinary or behavioral issues? Yes No Acknowledgement Statement By clicking here, I acknowledge...
