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WinthropThink CollegeAPPLICATION FOR 2022-2023 ACADEMIC YEARWINTHROP THINK COLLEGEWINTHROP UNIVERSITY320B WITHERS/W.T.S. BUILDINGRICHARD W. RILEY COLLEGE OF EDUCATIONROCK HILL, SC 29733Completed Application Deadline isDecember 12, 2021
WINTHROP THINK COLLEGE PROGRAMAPPLICATION FOR PROGRAM ADMISSIONApplications will not be considered for admission untilALL requested information is received.Winthrop University welcomes your application for admission to the Winthrop Think College Program. This program is acomprehensive program of study for unique learners who are highly motivated young adults with an intellectual disability.The mission of Winthrop University’s Think College Program is to provide an inclusive post-secondary educationexperience to students with intellectual disabilities to prepare them for competitive employment and active participationin local communities with as much independence as possible. The disability is characterized by significant limitationsboth in intellectual functioning and in adaptive behavior as expressed in conceptual, social and practical adaptive skillsand originates before the age of 18 (as defined by the American Association on Intellectual and DevelopmentalDisabilities – AAIDD).Please read the following instructions before completing the application. The applications can be typed or printed neatly.Application Checklist:m Complete the Winthrop Think College Program Applicationm Complete the Student Questionnaire (by applicant)m Complete the Personal Support Inventory (by the applicant).m Submit official high school transcript(s) including last IEP or any post-secondary program record.m Submit official discipline report from high school.m Submit copies of all Educational Evaluations conducted within the past three (3) years.m Submit all Psychological/Behavioral Evaluations conducted within the last three (3) years.m Submit a current Vocational/Occupational Screening or Assessment.m Please submit three (3) Student Recommendation Forms from references who have known the applicant forat least two calendar years. Submitted forms must represent the following areas: education (required) and atleast two recommendations from the following areas: 1) vocational/employment, 2) community involvementand/or 3) personal.Completed Student Recommendation Forms must be submitted with the application packet and mustbe in a sealed envelope with signature of the reference across the seal.m After initial screening of the application, a personal interview will be scheduled when a completed packet hasbeen received (required of all applicants.).Mail the completed application packet to:Winthrop Think College ProgramWinthrop University320B Withers/W.T.S. BuildingRichard W. Riley College of EducationRock Hill, SC 29733, USAApplication Date for Consideration:Application deadline is December 12, 2021 for the Fall 2022 cohort.For additional Information, Contact Winthrop Think College at wtc@winthrop.edu or visitwww.winthrop.edu/thinkcollegeNote: This is a certificate program (not an accredited college degree granting program), and exiting students will receive a certificate ofcompletion along with a personal portfolio – NOT a degree from Winthrop University.Due to space limitations, not all applicants who complete the application and meet the “criteria for admission” can beaccommodated in the Winthrop Think College Program. However, applicants who are not accepted are welcome toreapply for next year.1
Application Criteria:m Age 18-25 at the time of admission.m A documented intellectual disability with IQ between 45-75.m Ability to function independently for a sustained period of time (at least 4 hours).m The applicant should be able to sit through 120 minute courses.m The applicant must demonstrate the ability to accept responsibility for his/her actions and maintain respectfor him/herself and others and have no history of disruptive or aggressive behaviors. Winthrop Think Collegedoes not have the personnel necessary to manage behavioral issues.m The applicant must be independent in handling his/her own medication, specialized dietary and/or medicalneeds as well as in the use of his/her own medication. There is no personnel available to manage/administermedication. Winthrop Think College Staff takes no responsibility for specialized diets or medical needs.m Does not display significant maladaptive behaviors that would require extensive behavioral support.m Must be able to transverse the university campus with minimal adult supervision.m Demonstrates communication skills adequate to interact on the Winthrop University campus.m Demonstrates socially acceptable behavior that allows a favorable experience on Winthrop Universitycampus.m Motivated to learn and benefit from participation in the WTC program.m Transportation to and from campus is the responsibility of the participant and his/her caregivers.m Expresses interest in living and working as independently as possible in the community after completing theWinthrop Think College program.2
PROGRAM FEESFees for 2022-2023 Academic YearResidentialStudentCommuterStudentWTC ProgramFee 15,000Housing*Meal Plan* 5,858- 7,708 3,916- 4,104ResidentialMentor Fee 3,000 15,000N/AN/AN/ADepending on courses selected during registration, additional course fees may be added to studentaccounts.Additional charges for Orientation will be added for first year students.Information about possible funding sources can be found on our ul-links.aspx*University fees subject to change, fees listed are 2021-2022 fees. Meal plan calculations are basedon the “All Access” and “All Access Plus” plans.3
WINTHROP THINK COLLEGEAPPLICATIONAPPLICATION NOTES:1.2.3.4.Type or print in ink.Complete all of the application. If the question does not apply to you, write N/A.Provide the month and date(s) requested; do not use terms “current” or “present.”READ APPLICATION AGREEMENT, SIGN AND DATE YOUR APPLICATION1.TERM OF PROPOSED ENROLLMENT Fall Semester2.SOCIAL SECURITY NUMBER - -3.NAME Last Name Suffix (Jr., III, IV)YEARFirst Name Middle Name4.DATE OF BIRTH (mm/dd/yy)Does someone have legal guardianship of the student? mYes mNoIf yes name of guardian If yes, include copy of court documentation5.MAIDEN OR FORMER NAME USED AT OTHER COLLEGES6.HOME/PERMANENT ADDRESSStreetCity State ZIP code ZIP fourCounty7.MAILING ADDRESS IF DIFFERENT FROM ABOVEStreetCity State ZIP code ZIP fourCounty8.HOME TELEPHONE CELL TELEPHONE9.E-MAIL ADDRESS10. I AM AN INTERNATIONAL STUDENT (circle answer)YesI AM SEEKING AN F-1 STUDENT VISA mYes mNoNoCountry of birth Country of citizenshipI am a permanent resident of the United States mYes mNoAlien registration number (include a copy of both sides of your alien registration card or green card)11. MILITARY VETERAN/ACTIVE MILITARYAre you the spouse or a DEPENDENT of a full-time member of the U.S. armed forces?mSpousemDependent12. ETHNIC ORIGIN / RACEI am Hispanic or Latino?mYes mNoWhat is your race? Regardless of your answer to the previous question, please mark one or more races to indicate what youconsider yourself to be.mAmerican Indian or Alaskan Native mAsian mBlack/African American mNative Hawaiian or Other Pacific Islander4mWhite
13. FAMILY CONTACT INFORMATION (circle relationship to you) ParentSpouseGuardianOtherLast Name Suffix (Jr., III, IV)First Name Middle NameHome/permanent address (P.O. BOX, RFD, Street)City State ZIP Code ZIP fourTelephone Home Work CellE-mail address (please print neatly)14. I PLAN TO LIVE: mIn university housing mOff-campus15. DO YOU LIVE IN SOUTH CAROLINA? mYes (If yes, completion of the residency form is required.) mNoACADEMIC HISTORY16. HIGH SCHOOL YOU LAST ATTENDEDName of high schoolState Years attended (yyyy to yyyy) toHigh school graduation date: Month/Year (mm/yy) / or GED (mm/yy) / Issued in which state?17. LIST ALL COURSES IN WHICH YOU ARE CURRENTLY ENROLLED IN OR PLAN TO REGISTER FOR AND COMPLETE DURING YOUR SENIOR YEARIN HIGH SCHOOL.18. Did/will receivemHigh School DiplomaParticipated in general education classesmEquivalent CertificatemYesName of certificate received:mNoDescribe inclusive educational experiences/list inclusive classes:Attach a list of accommodations used in general education classes.What clubs or teams were you involved in?Awards or offices held?25
19. COLLEGES ATTENDED: Have you attended any college, either full-time or part-time, since graduation or taken any college-level courses while in high school? If yes, please list below all colleges attended, current or most recent first, and ask theinstitution(s) to forward an official transcript of your work directly to Winthrop University. The University may verify your previousattendance at all institutions through the National Student Clearinghouse.Name of school (full name) StateCredits earned Date entered (mm/yy) / Date leaving (mm/yy) /Name of school (full name) StateCredits earned Date entered (mm/yy) / Date leaving (mm/yy) /Name of school (full name) StateCredits earned Date entered (mm/yy) / Date leaving (mm/yy) /20. I FIRST LEARNED ABOUT WINTHROP THINK COLLEGE (circle the most appropriate)A) A family member who graduated from Winthrop UniversityNameRelationshipB) A family member who attended/currently attends Winthrop UniversityC) Alumnus referralD) A student currently attending Winthrop UniversityE) A Winthrop University faculty or staff member referralF) Meeting an admission counselor at a college fairG) A visit to campusH) A coach’s referralI) I received a mailing from Winthrop UniversityJ) The Winthrop University websiteK) Other. Specify:21. HOW CAN YOUR EDUCATIONAL EXPERIENCE AT WINTHROP UNIVERSITY HELP YOU ACHIEVE YOUR FUTURE GOALS?26
22. REQUIRMENTS OF THE WINTHROP THINK COLLEGE PROGRAMI fully understand that the following are the requirements of the completion of the program: Attend and complete all assignments within the Winthrop Think College curriculum and Winthrop classes with modifiedassignments. Cooperate with all Winthrop Think College staff. Fully participate in planned Winthrop Think College activities. Fully participate in job shadowing and employment activities. Adhere to the job placement requirements per the employment coordinator. Adhere to the independent living skills activity requirements. Fully comply with the Winthrop University Code of Student Conduct.Non-compliance with these requirements may result in the following: Academic warning Academic disciplinary team meeting with action plan Removal from Winthrop Think College23. APPLICATION AGREEMENTI certify that these responses are true and complete to the best of my knowledge, pursuant to reasonable inquiry where needed,and I am aware that any knowing omissions or falsification herein may result in disciplinary action including denial of admissionor dismissal after admission. Further, it is my understanding that I shall not be considered for admission to the Universityuntil I have submitted all credentials. I understand that if I discontinue my enrollment in Winthrop Think College atWinthrop University at any time, I must submit a new application by the appropriate deadline. I also understand that theprovision of my Social Security number and my ethnic/racial origin are not required to be considered for admission to WinthropThink College.My signature below is my promise that, should I enroll at Winthrop University, I will abide by all rules and policies of the Code ofStudent Conduct and Academic Responsibilities as outlined in the University’s Student Handbook. The handbook can be foundat ct/StudentHandbook.pdfSignature of Applicant DateSignature of Parent or Legal Guardian Date(If applicant is under 18 years of age)7
WINTHROPUNIVERSITYWINTHROPTHINK COLLEGERESIDENCY FORMRESIDENCY INFORMATION FOR IN-STATE TUITIONWINTHROPReturn to: Office of Admissions,WinthropUNIVERSITYUniversity, Rock Hill South, Carolina ns@winthrop.eduFAX:803-323-4952 TUITIONReturn to: Office of Admissions, Winthrop University, Rock Hill South, Carolina 323-4952** CLASSIFICATION ASA RESIDENTFOR TUITION PAYMENTIS NOT AUTOMATIC. **All applicants who claim residency in South Carolina or entitlement to in-state tuition are required to provide the requested information.PLEASE COMPLETE THIS**FORMIN ITS ENTIRETYWINTHROPID. INCOMPLETEWILL BE RETURNEDFOR COMPLETION.CLASSIFICATIONAS AINCLUDINGRESIDENT YOURFOR TUITIONPAYMENTPURPOSES FORMSIS NOT AUTOMATIC.**All applicants who claim residencyin South Carolinaor entitlementin-state tuitionareSCrequiredto provide the requested information.ADDITIONALINFORMATIONMAY BEtoREQUESTEDPERLAW 59-112.PLEASE COMPLETE THIS FORM IN ITS ENTIRETY INCLUDING YOUR WINTHROP ID. INCOMPLETE FORMS WILL BE RETURNED FOR COMPLETION.INFORMATIONMAYallBEREQUESTEDPERdelaysSC LAW59-112.A. Questions 1- 12 to be completed by allADDITIONALstudents. NOTE:please answerquestionsto avoidin processingyour residency application.B. Completion of questions12- 26 is required for:A. Questionsto be completedall students.NOTE:ANDplease answer all questions to avoid delays in processing your residency application.1. 1all12studentsyounger bythan24 years old;B. Completionof questions1226 is24required2. studentswho are ageor olderfor:and were claimed as a dependent for the last tax year.1. all studentsyoungerthan 24years old;AND3.C. The applicationis not completewithouta signatureon page2. students who are age 24 or older and were claimed as a dependent for the last tax year.C. The application is not complete without a signature on page 3.Name of Student:LastFirstMiddleName of Student:LastFirstMiddleCity of Birth:State of Birth:Country of Birth:City of Birth: State of Birth: Country of Birth:Date of Birth:(Month/Day/Year)Age:Date of Birth:(Month/Day/Year)Age:Semester you expect to begin classes: FallYear:Semester you expect to begin classes: FallYear:1. What is your citizenship status? US Citizen1. WhatyourcitizenshipResidentstatus? isUSPermanentDate permanent residency was granted (month/day/year) ForeignUS Citizen Citizen with valid VisaVisa Type: DeferredUS Permanent ActionResidentfor Childhood Arrivals Date permanent residency was granted (month/day/year) Foreign Citizen with valid VisaVisa Type: DeferredActionforChildhoodArrivals2. List all addresses where you have lived for the past two years (do not use Post Office box number).AddressDates of Residence2. List all addresses where you have lived for the past two years (do not use Post Office box number).AddressDates of ResidenceStreet AddressCityState Zip codeFrom: (month/year) To: (month/year)StreetAddressCityState Zip codeFrom: (month/year) To: (month/year)Street AddressCityState Zip codeFrom: (month/year) To: (month/year)StreetAddressCityState Zip codeFrom:(month/year) To: (month/year)Street AddressCityState Zip codeFrom: (month/year) To: (month/year)Street AddressCityState Zip codeFrom: (month/year) To: (month/year)3. Are you employed? No Yes (If yes, provide employer’s information below)3. Are you employed? No Yes (If yes, provide employer’s information below)EmployerCity, State, Zip codeBeginning date of employmentHours per weekEmployerState,( )Zip codeBeginningdateHours4.Telephone number where you can beCity,reached:Can a messagebe leftat ofthisemploymentnumber? Yes No per week4. Telephonenumber whereCan a message be left at this number? Yes No5.Are you married? Yesyou canNo beIfreached:yes, date( )of marriage?5. HaveAre you Yes NoserviceIf yes,datetheof lastmarriage?6.youmarried?been in activemilitarywithintwo years? Yes NoIf yes, State of Legal ResidenceIf yes, current duty station: Or Discharge date if applicable: Month/Day/Year6. Have you been in active military service within the last two years? Yes NoIf yes, State of Legal ResidenceIf yes,currentstation:Or Dischargeapplicable:7.Do youhavedutya driver’slicense? Yes No OR State issued identificationcard?date ifYes No Month/Day/YearIf yes, from what state?Issue date on license or ID card Month YearDo youhavea driver’slicense?Yesplanned No enrollmentOR Statedateissuedidentification whatYes No original date of issue? Month YearIf7.dateis lessthan12 monthsfrom your(January,May orcard?August),is theIf yes, from what state?Issue date on license or ID card Month YearIf dateis less12 monthsyour planned8.Do youhavethana motorvehiclefromregisteredin yourenrollmentname? dateYes (January, No May or August), what is the original date of issue? Month YearIf yes, in what state is the vehicle registered?Issue date on current motor vehicle registration Month YearDo youhavea motorvehiclefromregisteredin yourenrollmentname? dateYes(January, No May or August), what is the original date of issue? Month YearIf8.dateis lessthan12 monthsyour plannedIf yes, in what state is the vehicle registered?Issue date on current motor vehicle registration Month YearIf date is less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? Month Year8
Name Yes No Part-year resident Non-resident Yes No Part-year resident Non-resident 9. Did you file a South Carolina Income Tax Return for the 2020 tax year? YesYes NoNo Part-yearresident rn? Full-yearresident Part-yearresident Non-residentncome Tax Return for the 2020 tax year? Yes Nofile the return? Full-year resident Part-year resident Non-resident9.SouthIncomeTax Return2020 fortax theyear? YesYes NoNo10.DidDidyouyoufileor awillyou Carolinafile a SouthCarolinaIncomeforTaxtheReturn2021 tax year?Ifyes,underwhatstatusdidyoufilethereturn? Full-yearresident Part-year Non-resident Part-year residentresident Non-resident Full-yearYes NoIf yes, Incomeunder whatfile theresidentth CarolinaTax statusReturndidfor youthe 2021taxreturn?year? Part-yearresident Non-residentfile the return?Full-year resident Yes No10.or willyoureside?file a South CarolinaReturn for Motherthe 2021 tax year?11. DidWithyouwhomdo you Both IncomeParents Tax Father Part-yearresident Non-residentIf yes, Parentsunder what Fatherstatus did Motheryou file thereturn?Full-year resident Other:Name:Relationshipto you: Both Other: Name: Relationship to you:11. Withwhomdo youWHOreside? Both Father MotherTHE INFORMATION REQUESTED BELOW.** ALLPERSONSARE YOUNGERTHANParents24 YEARS OLDMUST PROVIDE Other:Relationshipto Ayou:** THE INFORMATION IS ALSO REQUIREDFORName:PERSONSWHO ARE 24 OR OLDER AND WERECLAIMED ASDEPENDENTFOR THE TAX YEARNameUNGER THAN 24 YEARS OLD MUST PROVIDE THE INFORMATION REQUESTED BELOW.PRECEDINGREQUIRED FORPERSONSYOURWHOENROLLMENT.ARE 24 OR OLDER AND WERE CLAIMED AS A DEPENDENT FOR THE TAX YEAR** ALL PERSONS WHO ARE YOUNGER THAN 24 YEARS OLD MUST PROVIDE THE INFORMATION REQUESTED BELOW.MENT.** THE INFORMATIONALSO REQUIRED12. Wheredo your parentsIScurrentlyreside? FOR PERSONS WHO ARE 24 OR OLDER AND WERE CLAIMED AS A DEPENDENT FOR THE TAX YEARPRECEDINGENROLLMENT.NameYOURCity State living deceasedy reside? Father’sMother’s NameCity CityState living deceasedState living deceased12. Where do your parents currentlyreside?CityState living deceasedNameCityState living deceasedWidowed NeverMarried13. Father’sMarital statusofparents: MarriedDivorced or Legally SeparatedMother’sNameCityState living deceasedIfDivorcedparents aredivorcedor legally separated, whoWidowedis (or was) the custodial Mother Joint-custody Neverparent?Married Fatherrriedor LegallySeparatedy separated, who is (or was) the custodial parent? Father Mother Joint-custodyWidowed Never Married13.statusof parents:Divorced or Legally Separated15. MaritalWhen didresidencein SouthMarriedCarolina begin?14.If parents are divorced or legally separated, who is (or was) the custodial parent? Father Mother Joint-custodyarolina begin?Father: Month/Year Mother: Month/Year15. When didresidencein South Carolinabegin?Mother:Month/Year16. When were you last claimed as a dependent on a federal income tax return? Year By For what state?15.14.Father:Mother: Month/Yeara dependenton Month/Yeara federal incometax return? YearByFor what state?17. Have either of your parents been in active military service within the last two years?16.16. Whenwereyou lastclaimeda dependenton a federal income tax return? Year By For what state?n in activemilitaryservicewithinthe lastastwoyears?Father: Yes NoMother: Yes NoIf yes, State of Legal Residence17. Haveeither of yourparentsbeenactivemilitary servicewithin the last two years?er: Yes NoIf yes,Stateof inLegalResidenceIf yes, current duty station: Or Discharge date if applicable: Month/DayYearFather: Yes NoMother: Yes dateNo if applicable:If yes,Month/DayYearState of LegalResidenceOr Discharge17.18. What is the citizenship status of each person listed below? **IfFather:yes,listedcurrentdutyOr Dischargedate if applicable:Month/DayYear USCitizen US Permanent Resident– EffectiveDate: ForeignCitizen with validVisa– Visa Type:f each personbelow?** station:Mother: USCitizen USPermanentResident–EffectiveDate: ForeignCitizenwithvalidVisa– Visa Type: US Permanent Resident– Effective Date: Foreign Citizen with valid Visa– Visa Type:18. Whatis the citizenshipof eachlisted below?** USPermanentResident–statusEffectiveDate:person ForeignCitizen with valid Visa– Visa Type:Father: US CitizenPermanentResident–EffectiveDate: ForeignCitizenwith validVisa–VisaType:** REQUIRED:If citizenshipstatus is USpermanentresidentor foreigncitizenwitha valid visa, pleaseattacha legiblecopyof thedocument.Mother: USCitizen USPermanentResident–EffectiveDate: ForeignCitizenwithvalidVisa–VisaType:us is permanent resident or foreign citizen with a valid visa, please attach a legible copy of the document.18. List all addresses for where the persons below have lived for the past two years (do not use Post Office box number).** REQUIRED:If th a valid visa, please attach a legible copy of the document.he personsbelow havelived for thepastistwoyears (donot useorPostOfficebox number).Father’s AddressDates of Residencethe pasttwo years (do not use Post Office box number).ess 18. List all addresses for where the persons below have lived forDatesof ResidenceFather’s AddressDates of ResidenceStreet AddressCityState Zip codeFrom: (month/year)To: (month/year)CityState Zip codeFrom: (month/year) To: et AddressCityState Zip codeFrom: (month/year)(month/year) To:To: (month/year)(month/year)CityState Zip codeFrom: (month/year) To: et AddressCityState Zip codeFrom: (month/year)(month/year) To:To: (month/year)(month/year)CityState Zip codeFrom: (month/year) To: (month/year)Mother’s AddressDates of ResidenceStreetAddressCityStateZipcodeFrom: (month/year) To: (month/year)essDates of ResidenceMother’s AddressDates of ResidenceStreet AddressCityState Zip codeFrom: (month/year)To: (month/year)CityState Zip codeFrom: (month/year) To: et AddressCityState Zip codeFrom: (month/year)(month/year) To:To: (month/year)(month/year)CityState Zip codeFrom: (month/year) To: et AddressCityState Zip codeFrom: (month/year)(month/year) To:To: (month/year)(month/year)CityState Zip codeFrom: (month/year) To: (month/year)Street AddressCityState Zip codeFrom: (month/year) To: (month/year)9
Father:EmployerCity, State, Zip codeBeginning date of employmentHours per weekMother:NameWinthrop ID Number:Page 3 of 3EmployerCity, State, Zip codeBeginning date of employmentHours per week20. What is the current employment status of each person listed below?Father:EmployerCity, State, Zip codeBeginning date of employmentHours per weekMother:EmployerCity, State, Zip codeBeginning date of employmentHours per week21. Who claimed you as a tax dependent for federal and state income taxes for the 2020 tax year (check one)? Father and Mother Father Mother Self Other Person I filed a joint return with my spouseA. His/Her/Their Federal Filing Status: Single Married, filing jointly Married, filing separately Head of householdB. South Carolina State Filing Status: Resident Non-Resident Part-year ResidentC. A South Carolina return was not filed for the following reason22. Who claimed or will claim you as a tax dependent for federal and state income taxes for the 2021 tax year (check one)?21. Who claimeda tax dependentfederal and stateincome taxesthe 2020 taxone)? FatheryouandasMother Father for Mother SelfOtherforPerson yearI filed(checkor will filea joint return with my spouse Father and Mother Father Mother Self Other Person I filed a joint return with my spouseA. His/Her/Their Federal Filing Status: Single Married, filing jointly Married, filing separately Head of householdA. SouthHis/Her/TheirFederalFiling Status:Status: filing jointly Married,filing separately Head of householdB.CarolinaState Filing SingleResident Married,Non-Resident Part-yearResidentB.SouthCarolinaStateFilingStatus: Resident Non-Resident Part-yearResidentC. A South Carolina return was not filed for the following reasonC. A South Carolina return was not filed for the following reason23. ADDITIONAL INFORMATION – forms submitted without the issue date for the parent(s) who claim the student will be returned.22. Who claimed or will claim you as a tax dependent for federal and state income taxes for the 2021 tax year (check one)? FatherInformationand Mother - Does Father Selfor State OtherPersonYes fileissueda joint returnwithstate?my spouseA.Father’she have Mothera driver’s licenseID card?No I filed or Ifwillyes,by whatIssuedate on current license Month Year NewRenewal **FederalFiling Status: Single Married,jointlywhat isMarried,filingdateseparately Headof householdIf lessA.thanHis/Her/Their12 months fromyour plannedenrollmentdate (January,May orfilingAugust),the originalof issue? MonthYearB. South Carolina State Filing Status: Resident Non-Resident Part-year ResidentDoesC.he havea motorvehicleregisteredin hisYesreasonNoIf yes, in what state is the vehicle registered?A SouthCarolinareturnwas not filedforname?the followingIssue date on current motor vehicle registration (Month/Day/Year) New** Date of Purchase RenewalIf lessthan 12 monthsfrom your plannedenrollmentdate(January,or dateAugust),whatparent(s)is the originaldate oftheissue?Month23.ADDITIONALINFORMATION– formssubmittedwithouttheMayissuefor thewho claimstudentwill Yearbe sDoesheshehavea driver’slicenseStatecard? YesYes NoNoIf yes, issued by what state? IssueA.Father’shavea driver’slicenseororStateIDIDcard?date on current license Month Year NewRenewal **If less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? Month dregisteredininhishername?name? YesYes NoNoDoes heIf yes, in what state is the vehicle registered?Issue date on current motor vehicle registration (Month/Day/Year) New** Date of Purchase RenewalIf less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? Month YearB.Mother’s Information – Does she have a driver’s license or State ID card? Yes NoIf yes, issued by what state? Issuedate on current license Month Year NewRenewal **If less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? Month YearDoes she have a motor vehicle registered in her name? Yes NoIf yes, in what state is the vehicle registered?Issue date on current motor vehicle registration (Month/Day/Year) New** Date of Purchase RenewalIf less than 12 months from your planned enrollment date (January, May or August), what is the original date of issue? Month Year24. I hereby certify that the information I have provided is accurate and that I am making this application in good faith based on the belief that I am eligible to paytuition and fees at the rate afforde
ink College APPLICATION FOR 2022-2023 ACADEMIC YEAR WINTHROP THINK COLLEGE WINTHROP UNIVERSITY 320B WITHERS/W.T.S. BUILDING RICHARD W. RILEY COLLEGE OF EDUCATION ROCK HILL, SC 29733 Completed Application Deadline is December 12, 2021
