Background/ Prior Record

Background Information

Failure to disclose an incident or the full details of any incident will subject you to potential revocation of your on-campus housing.

Date of most recent incident(Required):

This field is required.

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Approximate date of most recent offense

Time of incident:

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Approximate time of most recent offense

In what state were you charged(Required):

This field is required.

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select the state you were charged in

Other states?:

Involved Party

Please include your FIRST and LAST Name as you stated on your application

First and Last Name

Select Gender

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Hall/Address

Questions

Have you been CONVICTED of a Felony or Misdemeanor?(Required)

Felony Misdemeanor Charged but Not convicted

This field is required.

Do you have any PENDING criminal charges?(Required)

Yes No Unsure

This field is required.

Please describe in detail the incident in which you were involved. Include the date, classification, circumstance, location and your current status here.(Required) This field is required.

What did you learn from the incident?(Required) This field is required.

Why do you want to live in the Residence Halls?(Required) This field is required.

What are your educational goals?(Required) This field is required.

What would your message to other students be?(Required) This field is required.

What are you willing to do to be successful at AWC? ("Anything" is not an acceptable answer)(Required) This field is required.

What do you expect of AWC staff to help you be successful?(Required) This field is required.

Are you transferring from another college/university?(Required)

Yes No

This field is required.

If you are transferring from another college or university please explain why you are transferring. (if you are not transferring please write "N/A")(Required) This field is required.

Supporting Documentation

You must upload copies of your police report, sentencing report, court order, probation paperwork, counseling release information or any other information that may be helpful for us in making a decision. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Background Information

Involved Party

Questions

Supporting Documentation

Submission