Educational Success Program Enrollment Form - Northwood University Forms

Name *

First Middle Initial Last

Gender

Male
Female

Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home phone *

Cell phone *

College major *

High school attended *

Student email *

Parent email(s) *

Students who wish to receive academic accommodations in accordance with the Americans with Disabilities Act of 1990 and Section 504 of the Disabilities Act of 1973 during ESP will need to make arrangements prior to attending. Would you like more information about academic accommodations during ESP? *

Yes
No

Please share any specific questions you have at this time. *

Do you have any food allergies/dietary preferences we need to know about in advance of the program? *

Yes
No

Please indicate your food allergies/dietary preferences. *

Do you have religious/spiritual beliefs we may need to consider during the program? *

Yes
No

Please explain what you would like us to consider regarding your religious/spiritual beliefs. *

Is there anything else you would like us to consider in advance of the program? *

Yes
No

Please provide your additional considerations. *

Agreement to participate in ESP *

Please read the following statements carefully. By clicking each box, you are acknowledging you understand what is stated and will take part in our ESP as outlined.

I understand I need to attend New Student Orientation sessions in addition to the ESP.
The ESP is designed to help me prepare for the educational and social challenges of college.
I understand the Educational Success Program (ESP) is an eleven-day commitment held prior to semester start.
I understand I will reside on Northwood’s campus for the duration of the ESP.
I plan to fully participate in the ESP, be prepared for and arrive on time to scheduled events.
I am aware I must successfully pass the ESP in order to remain enrolled and begin my first semester at NU.

If you have any questions about the program, please get in touch with your Admissions Representative.

Type your full name *

(Constitutes electronic signature)

Student ID# *

Today's date

Name

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