PLEASE PRINT THIS PAGE TO COMPLETE YOUR APPLICATION
CONFIRMATION
Thank you for your interest in the Pre-College Program at Fayetteville State University. Your application will not be reviewed until we have received all supporting materials. You will need to submit the following information to complete your application:
  • Sign and return this sheet only stating that you have reviewed the Rules and Regulations of our program. Please keep a copy for your own records.
  • $45.00 Application Fee (Made payable to the FSU PIE Club) (Refunds only to students not accepted into the program). Parents may call the Pre-College Program for the rate for families with more than one child interested in attending the program
  • Your student's most recent report card

All actions taken by the MSEN Pre-College Office, due to misconduct, will be presented to you in writing.  You and your child must agree with the guidelines as stipulated by the Fayetteville State University Pre-College Program in order to be enrolled as an MSEN Pre-College student.  Please sign and return this form ONLY to the Pre-College Office (address listed below). Failure to return this sheet stating that you have reviewed the Rules and Regulations of our program will hinder your child's enrollment and participation in the MSEN Pre-College Program. 
  

I give permission for                                                                       to participate in the MSEN Pre-College Program; for program staff to obtain information about his/her academic performance from schools, school districts, the State Department of Public Instruction and colleges, whether or not he/she continues in the program; to use his/her photos in MSEN publications; and to share his/her address with college and employer representatives. My signature also attests that I agree to all of the program's provisions and requirements.  The student's signature indicates that he/she also agrees to these provisions and requirements.

Grade for 2008-2009:                        
Status (New Enrollee/ Re-Enrollee):                           
Address:                                          
Home Ph#:                                       
Email:                                              

Please indicate with a check if the following items are included:
_____ Application Fee

_____ Student's most recent report card

 Date:____________________

Student's Signature:_________________________   Parent's Signature:_________________________

Return this sheet ONLY to:
Fayetteville State University
MSEN Pre-College Program
1200 Murchison Road, SBE 205
Fayetteville, NC 28301-4298

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