freshman application packet

Thank you again for applying to the University of MinnesotaTwin Cities! This packet contains this
checklist and a copy of your application. You may print this packet for your records.

Next steps for fall 2015 applicants

The items listed below are required to complete an application.
$55 application fee
To pay your nonrefundable fee by credit card, log back in to your application (www.uofminn.org/apply).
You will be brought to the Thank You page because you have already submitted your application. Select
Pay Online Now. (Fee waivers are available for eligible students. Visit
http://www.admissions.tc.umn.edu/PDFs/fee_waiver.pdf to learn more.)
Official ACT with Writing or SAT scores sent directly from the testing agency. Details are
available at http://www.admissions.tc.umn.edu/admissioninfo/fresh_writing.html.
Both ACT and SAT will send your scores free of charge to the first four schools you list when
you register for the test.
ACT U of M school code is 2156
SAT U of M school code is 6874
We will always consider the best overall official test score you submit, so we strongly encourage
you to list the U of M as one of the schools to receive your official score each time you sit for an
ACT or SAT exam.
Official high school transcript(s).
If you have completed any college coursework, even if no credit was earned, official transcripts
submitted from each college or university you attended are required.
The priority deadline to submit a complete application is December 15, 2014. Please note that after December 15,
space is limited and admission is more competitive.

Office of Admissions
University of Minnesota
240 Williamson Hall
231 Pillsbury Drive SE
Minneapolis, MN 55455
Website: http://admissions.tc.umn.edu
Phone: 1-800-752-1000 or 1-612-625-2008
Fax: 1-612-626-1693

Official Document Request

Student:
 o complete your application, please sign and date this form and deliver it to your school counselor
T
immediately. That way, we can give you our fastest admission decision.

Caleb Grochalski
330 Swain Hill Road
Evans City, PA 16033

Student release and waiver status:

By signing below, I grant my high school permission to release my transcripts to the University
of MinnesotaTwin Cities.

Caleb Grochalski

10/01/2014 02:02

STUDENT NAME

DATE

Counselor:
Your student referenced above has just submitted an application for admission to the University
of MinnesotaTwin Cities. Please take a moment to forward us the following at your earliest
convenience:
Official high school transcript

Upload the documents now.

For your convenience, you can send documents electronically right now with SENDedu, a
secure document transfer service with over 55,000 accounts. Simply go to SENDedu.org/login,
enter the student PIN below, and create an account (if you havent already).

Student PIN: HMXMN2VQX

Or you may fax or mail documents to:

Fax Number: 1-612-626-1693

Mailing Address: O
 ffice of Admissions, University of MinnesotaTwin Cities,
240 Williamson Hall, 231 Pillsbury Drive S.E., Minneapolis, MN 55455-0213

Thank you so much for your prompt attention in submitting these documents.

6874AI0088

University of Minnesota-Twin Cities - Freshman Application for Admission

Personal Information
First name

Caleb

Middle name

Jamison

Last name

Grochalski

Social Security number (optional)

210-76-3994

Info: Social Security number

Date of birth (optional if 18 or older)

08/06/1997

Gender (optional)

Male

Contact Information
Address line 1

330 Swain Hill Road

Address line 2
City

Evans City

State/Province

Pennsylvania

ZIP/Postal code

16033

Country

United States

Do you primarily live with a single parent?

No

Cell phone

724-789-7686

[X] I give permission to the Office of Admissions to send me updates via text messaging. (Standard message charges
apply.)
Home phone

724-290-3422

Other phone

--

Email address

calebjames227@gmail.com

Important information about your application will be sent to this email address. Please provide the email address you check
regularly.

Ethnicity & Race

Providing the information below is voluntary and will not be used in a discriminatory manner. These questions comply with the
U.S. Department of Education's standards for ethnic and racial data collection.

Ethnicity
Are you Hispanic or Latino?
Info: Ethnicity

No

Race
Please select one or more that apply.
Info: Race
[ ] American Indian or Alaska Native
[ ] Asian
[ ] Black or African American
[ ] Native Hawaiian/Other Pacific Islander
[X] White

Residency
Are you a U.S. citizen?

Yes

State in which you claim legal residence

Pennsylvania

Info: Residency

When did you move to that state?

OR

[X] Lived there all my life

Family Background
Has either of your parents received a four-year
undergraduate degree from a college or
university?
Have any members of your family been
employed by the University of Minnesota?
Have any members of your family attended the
University of Minnesota-Twin Cities?

Yes

No
No

Semester
Semester you wish to begin

Fall 2015 (Semester begins September 2015)

NOTE: Freshman admission is offered only for fall semester.

College & Major

The University of Minnesota offers more than 140 majors for undergraduates. Accepted freshmen are admitted directly to one of
the University's freshman-admitting colleges* based on their academic interests and preparation. A profile of admitted freshman
applicants by University of Minnesota college is available.
Please indicate your major interest below.

Major and College of Interest

Your College Choice: College of Liberal Arts

Acting

If you have another major interest, select it

here.

Dance

Your College Choice: College of Liberal Arts

*University of Minnesota freshman-admitting colleges

College of Biological Sciences (CBS)
College of Design (CDes)
College of Education & Human Development (CEHD)
College of Food, Agricultural and Natural Resource Sciences (CFANS)
College of Liberal Arts (CLA)
Carlson School of Management (CSOM)
College of Science and Engineering (CSE)
Explore Majors and Colleges

Future Plans (optional)

Do your future plans include obtaining a
graduate or professional degree?
If yes, please indicate your interest(s) below.

Maybe

[ ] Architecture
[ ] Audiology
[ ] Dental Hygiene*
[ ] Dentistry
[ ] Education (Teaching Licensure)
[ ] Graduate School (Master's or Ph.D.)
[ ] Landscape Architecture
[ ] Law
[ ] Master of Business Administration (MBA)
[ ] Medical Laboratory Sciences (formerly Clinical Laboratory Science)
[ ] Medicine (Medical Doctor)
[ ] Mortuary Science*
[ ] Nursing*
Details about the Freshman Nursing Guarantee Program

[ ] Occupational Therapy
[ ] Pharmacy
[ ] Physical Therapy
[ ] Public Health
[ ] Veterinary Medicine

*This professional program can be completed as a four-year undergraduate degree.

Educational Background
Is English your native language?

Yes

High School(s)
Look up and enter your current high school information.

Current High School

School name

Lincoln Park Performing Arts C

Address

1 Lincoln Park

City

Midland

State/Province

PA

ZIP/Postal code

15059-1535

Country

US

From

08/2011

Example: September 2011

To

06/2015

Example: June 2015

Expected/actual graduation date

Month of graduation

June

Year of graduation

2015

High School Guidance Counselor

Please provide the following information about your high school guidance counselor. Once you submit your application, an email
will be sent to your counselor asking him or her to submit your high school transcript to help you complete your application.
Counselor first name

Courtney

Counselor last name

Campbell

Counselor email

courtney.campbell@lppacs.org

College(s)
List any universities (including the U of M) or colleges where you have taken or will take courses while attending high school,
including PSEO and College in the Schools (CIS).
NOTE: If you have registered or enrolled at a college, university, or any other school after high school graduation, you are
considered a transfer student. A different application is required. Please contact the Office of Admissions.

College 1
School name

Community C Beaver County

Address
City

Monaca

State/Province

PA

ZIP/Postal code
Country

US

Credits completed

9.0

From

08/2013

Example: August 2010

To

06/2015

Example: May 2014

Senior-Year Classes
List all high school or college classes completed, or to be completed, during your senior year in high school. (Examples: AP
Calculus, History, IB Literature Higher Level, Honors English, French, Economics, Band).
*Any changes to the schedule below must be communicated to the Office of Admissions.
Course title

Jazz 404

Term (e.g., Fall 2014)

Full Year

Course title

Ballet 404

Term (e.g., Fall 2014)

Full Year

Course title

Tap 404

Term (e.g., Fall 2014)

Full Year

Course title

Acting 401

Term (e.g., Fall 2014)

Full Year

Course title

Musical Theatre Repertoire 401

Term (e.g., Fall 2014)

Full Year

Course title

Musical Theatre History

Term (e.g., Fall 2014)

Full Year

Course title

Senior Seminar

Term (e.g., Fall 2014)

Full Year

Course title

World History

Term (e.g., Fall 2014)

Fall 2014

Course title

Government/ Economics

Term (e.g., Fall 2014)

Fall 2014

Course title

College Algebra

Term (e.g., Fall 2014)

Spring 2015

Course title

English Composition 2

Term (e.g., Fall 2014)

Spring 2015

Program Participation
Check any of the following programs in which you have participated.

[ ] AVID
[ ] College Possible
[ ] FIRST Robotics
[ ] LearningWorks
[ ] National Achievement Semifinalist
[ ] National Merit Semifinalist
[ ] Project Lead The Way
[ ] St. Paul MEP
[ ] UMTYMP

TRiO Programs
[ ] Educational Opportunity Centers Program
[ ] Gear Up
[ ] Talent Search
[ ] Upward Bound

Special Circumstances (optional)

If you have any circumstances or additional information that you would like us to consider, please include an explanation
below. (Maximum 4,000 characters.)
Applying for BFA Actor Training Program with a possible double major in Dance

School-Sponsored Activities
Please list any school-sponsored activities such as clubs, music, student government, etc.

Name of activity

International Thespian Society

Grades participated

[X]
[X]
[X]
[X]

Leadership position(s) and school year(s) held

Member 9-12

Name of activity

Theatre

Grades participated

[X]
[X]
[X]
[X]

Leadership position(s) and school year(s) held

Cast in various plays/musicals/dance concerts

Name of activity

Dance

Grades participated

[X]
[X]
[X]
[X]

Leadership position(s) and school year(s) held

Cast in various Ballets/Dance Concerts

9th
10th
11th
12th

9th
10th
11th
12th

9th
10th
11th
12th

Activities Outside School

Please list any activities outside school you have participated in such as community service, volunteer service, scouting, 4-H,
FFA, etc.
Name of activity

Front Porch Theatricals Intern

Grades participated

[ ]
[ ]
[ ]
[X]

Leadership position(s) and school year(s) held

Choreographer's Intern

9th
10th
11th
12th

Other Talents, Achievements, Activities

Please list any other special talents, honors, achievements, awards, or activities that don't fit above. (Maximum 4,000
characters.)

Work Experience
Place of employment

12 Oaks mansion

Job title

Kitchen Staff

City

Mars

State/Province

Pennsylvania

From

03/2014

To

06/2015

Hours per week

12

Place of employment

Vogel Disposal Service

Job title

Office Assistant

City

Mars

State/Province

Pennsylvania

From

06/2013

To

08/2015

Hours per week

18

Military Service
Are you currently serving or have you ever
served in the U.S. Military?

No

Additional Required Information

The University of Minnesota is committed to maintaining an educational environment characterized by safety, respect, and
integrity. Answering yes to either question below does not automatically preclude admission to the U of M, but it may require
further review.
Have you ever been expelled from, suspended
from, or placed on probation at any high school
or college for reasons of academic dishonesty
or because of an offense that harmed or had
the potential to harm others, or are you
ineligible to return to any high school or college
you have attended?
Have you ever been convicted of a criminal
offense (felony, misdemeanor, or juvenile
offense) other than a minor traffic violation, or
is any such charge now pending against you?

No

No

Almost finished, Caleb! After you hit the Submit My Application button, you will be able to:
Download/Print a copy of your application
Pay your application fee
See a checklist of items required to complete an application

Access to your file

I authorize the University of Minnesota to give information about my application file, admission, or scholarship status to the
following person(s):

First name

Claudine

Last name

Grochalski

Relationship to you

Parent/guardian

Email address

claudinevg@gmail.com

First name

Paul

Last name

Grochalski

Relationship to you

Parent/guardian

Email address

paulgroch@zoominternet.net

Signature
I certify that the information I have provided on this application and on all other application materials is complete, accurate, and
true to the best of my knowledge. I understand that withholding pertinent information requested on this application or providing
false information will make me ineligible for admission, or subject to cancellation of registration if admission has occurred, or
subject to sanctions from the U of M, including dismissal, from the U of M, if already enrolled. I agree to notify the Office of
Admissions if there are any changes to the information provided in my application. In addition, I authorize the release of
information provided in my application, as well as my admission, honors, and scholarship status, to my high school and to
scholarship donors. I also authorize the University of Minnesota to release the information provided by me, as well as other
University of Minnesota information regarding my academic progress and status, to scholarship donors and the U of M
Foundation for the purpose of providing them with information concerning my eligibility as a scholarship recipient.
[X] Please check this box if you agree to these terms. Then type your full name in the box below.
Name

Caleb J Grochalski

PLEASE NOTE: After clicking Submit My Application, you will receive an email confirming that your application was submitted.
Although you will not be able to modify your application, you will have the option to print a copy for your records.