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    Online Visiting Student Data Form

    Please submit your student data in order to create a visiting student account. Only enter your information once as completing the application multiple times can lead to errors in processing your submission. Account activation can take four to six hours after completion of this form.
    * Indicates a required field
    Select a Term.
    NAME
    Enter your name information. Please use upper and lower case accordingly.
    PERMANENT ADDRESS AND PHONE
    Enter your Address information. You must enter a city and either a state or province and zip code or a country code. Please use upper and lower case accordingly.
    PERSONAL INFORMATION
    Enter your Personal Information.
    Birthdate *
    Birthdate *
    Sex *
    Sex *
    Citizenship *
    Citizenship *
    Are you a NY Resident?
    Are you a NY Resident?
    Please indicate whether or not you are Hispanic or Latino
    Please indicate whether or not you are Hispanic or Latino
    Select one or more races to indicate what you consider yourself to be
    Select one or more races to indicate what you consider yourself to be
    HIGH SCHOOL

    Suggestion: Type your state or country abbreviation, then school name to narrow your search results.
    Click your School name from the drop down.

    If your institution is not listed, please search for "Unlisted" and make your selection.

    PREVIOUS COLLEGE

    Suggestion: Type your state or country abbreviation, then school name to narrow your search results.
    Click your School name from the drop down.

    If your institution is not listed, please search for "Unlisted" and make your selection.

    ADDITIONAL INFORMATION
    Have you been dismissed and/or suspended from a college and/or university for disciplinary reasons? *
    Have you been dismissed and/or suspended from a college and/or university for disciplinary reasons? *
    INTERNATIONAL INFORMATION
    Please enter your visa and international information. If a visa type is entered, then a visa number and start and end dates must be entered as well. International information such as country of citizenship can be entered without entering any visa information.
    Visa Issue Date
    Visa Issue Date
    Visa Expiration Date
    Visa Expiration Date
    ADMISSIONS AGREEMENT

    I understand that withholding information requested on this application, including attendance at any other institution, or giving false information may make me ineligible for admission to the college or subject to dismissal. I have read this application and certify that the statements I have made on this application are correct and complete, including a report of all college work attempted or completed.

    Your registration for course(s) means you assume responsibility for paying all tuition and fees associated with your registration. Unless you drop courses or withdraw from the College by the published deadlines, you are responsible for the charges even if you do not attend or log into a single class. The liability and refund policy is available on the Student Financial Services web page.

    My acknowledgement below indicates that I understand that College policies including the Community Standards of Conduct as referenced in the Purchase College Student Handbook and the Institutional Response to Alcohol and Other Drugs are available online at https://www.purchase.edu/college-policies

    I agree to the terms *
    I agree to the terms *

    Please only enter your information once as completing the application multiple times can lead to errors in processing your submission.