BSSW Program Application Application for Admission Bachelor of Science in Social Work CUNYFirst ID: Name Date of Birth Country of Birth Preferred Phone Contact Home, Work or Cell Gender Male Female Nonbinary Marital Status Married Single Widowed Divorced Separated School EMail Personal Email Ethnicity Please check one. This information will be used for statistical purposes only *Affirmative Action Policy: The Social Work Program does not discriminate on the basis of race, color, religion, creed, gender, ethnicor national origin, disability, age, political or sexual orientation. American Indian or Alaskan Native (Not Hispanic or Latino) Asian (not Hispanic or Latino) Black or African American (not Hispanic or Latino) Hispanic or Latino Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) White (not Hispanic or Latino) Two or More Races (Not Hispanic or Latino). Prefer not to answer Have you matriculated at York College? Yes No Have you completed a total of 45 acceptable credits? (this includes transfer credits) Yes No Have you earned an overall GPA of 2.70 or higher? (this includes all earned credits) Yes No Have you earned a “C” or higher in SCWK 101? Yes No If you are a transfer student, have you earned a “C” or higher in all social work courses? Yes No Digital Signature Certification: All of the information on this form and any attached documentation on this application is true and complete to the best of my knowledge. I realize that false information may result in the rejection of my application. Place your full name below, please. Thank you.