IUPUC Temporary Intercampus Transfer


Please select one of the following:

New application for an upcoming term
Making changes to a previously submitted application (major, starting date/term, address, name changes only)

Student Information:
First:         Middle:         Last:

Previous Names used on other IU Campuses
Other First:         Other Middle:         Other Last:

Email Address:
*Birthdate (required): MM/DD/YYYY
Your Ten Digit University Identification Number:     
* This information is being used only to locate your information in the IU system

Home Address:
Street Address:
City: State: Zip:         Phone:

For Indiana Residents:
County:
On-Campus Address (if applicable):
Street Address:

City: State: Zip:         Phone:

County:

Semester of Transfer:
Summer 2018 Fall 2018 Spring 2018


Campus Transfer FROM:
Bloomington East Fort Wayne Indianapolis Kokomo Northwest South Bend Southeast

Behavioral Disclosure
We are committed to maintaining a safe learning environment. As part of that commitment, Indiana University requires applicants to disclose if they

  • have been subject to formal disciplinary action (including for example, but not limited to, suspension or expulsion for academic or non-academic reasons at any high school, post-secondary institution, college or university;
  • have been charged with or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court;
  • and/or have engaged in behavior that caused injury to person(s) or personal property (including for example, but not limited to, vandalism or behavior that led to a restraining order against you) which resulted in some form of discipline or intervention.

A previous disciplinary action, charge, conviction, or conduct of the sort identified here does not automatically disqualify applicants from admission to IU, but they do require review by the campus admissions committee.
PLEASE NOTE: By submitting your application to Indiana University, you acknowledge and agree that you have a continuing obligation to inform the University of any formal disciplinary action

  • for academic or non-academic reasons at any educational institution;
  • any legal charges and/or convictions (or foreign legal equivalents) that have not been expunged by a court;
  • and/or any behavior that causes injury to person(s) or property which results in some form of discipline or intervention that occurs from now until your enrollment at IU.

You must provide updated information to the campus admissions committee prior to class registration or class attendance, whichever is applicable. At that time, the campus admissions committee will review the information provided and may consider whether to delay or rescind your admission to IU.

Behavioral/Disciplinary Disclosure

1) Have you been subject to formal disciplinary action (including for example, but not limited to, suspension or expulsion) for academic or non-academic reasons at any high school, post-secondary institution, college, or university?
Yes No

2) Have you ever been charged with or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court?
Yes No

3) Do you have any currently pending criminal charges (or a foreign legal equivalent) against you?
Yes No

4) Have you engaged in any behavior that caused injury to any person(s) or property (including, for example, but not limited to, vandalism or behavior that led to a restraining order against you) which resulted in some form of discipline or intervention?
Yes No

By action of submitting this application, I acknowledge the following:

I understand that withholding pertinent information requested on this application or giving false information will make me ineligible for admission to IUPUC or subject to cancellation of admission if admission has already been granted or dismissal if already enrolled.

I certify that all statements on this application are complete and correct, including the list of all schools attended.

If necessary I will send a letter describing criminal or disciplinary history as described at the following website at Criminal Activity Disclosure Policy. The letter will be sent by certified mail and I will keep the receipt certifying it was received by IUPUC.  The letter contains a statement granting my permission to officials at all institutions and agencies involved to release information needed by IUPUC to substantiate statements I have made in my letter.  If you are applying close to the deadline date it may not be possible for your application to be processed prior to the start of the academic semester.

   

Indiana University -- Quality Education.  Lifetime Opportunities.

Comments: IUPUI Registrar
Copyright 2002, The Trustees of Indiana University