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Midland Lutheran College Application

Application Information

Please complete the following application to be sent directly to the Office of Admissions.

Following the submission of this form, you will receive an email confirming that Midland Lutheran College has received this form. If you do not receive a confirmation email please call the Office of Admissions at 800.642.8382 ext. 6501.


Personal Information
First Name:
Middle Name:
Last Name:
Maiden Name:
Preferred First Name:
Mailing Address:
City:
County:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Nonresident alien:
A person who is not a citizen or national of the United States and who is in this country on a visa or temporary basis and does not have the right to remain indefinitely.
Are you a Non-Resident Alien?
Additional Information
Gender:
Date of Birth:
What type of student are you?
Hometown Newspaper:
Hometown Newspaper City:
Hometown Newspaper State:
Enrollment Information
Session of Enrollment
Year of Enrollment:
Enrollment Status:
Residence Plans:
If "Other" please specify:
Intended area of study:
1st choice:
2nd choice:
High School Information
High School:
High school city:
High school state:
Graduation Date:
College Information
College 1:
City:
State:
Dates attended, start:
Dates attended end:
Graduation date:
College 2:
City:
State:
Dates attended, start:
Dates attended, end:
Graduation date
Have you ever attended MLC before?
Activities Information
Please rank your level of interest in collegiate activities. If enrolling in the iMpact Adult Degree Program, please skip to next section.
1 - Highest Interest:
2:
3:
4:
5 - Lowest Interest:
Do you plan to participate in college athletics?
If yes, please indicate the sport you wish to participate in.
Family Information
With whom do you reside?
Please provide the following information on the person(s) with whom you reside.
Relationship to you:
Title:
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Relationship to you:
Title:
First Name:
Last Name
Address 1:
Address 2:
City:
State:
Zip Code:
Sibling 1
First and Last Name:
Age:
Grade in school:
Name of School:
City of school:
State of school:
Sibling 2
First and Last Name:
Age:
Grade in school:
Name of School:
City of school:
State of school:
Please identify if your mother, father, brother, and/or sister is a current student or graduate of Midland Lutheran College.
First and Last name:
Status:
Relationship to you:
First and Last Name:
Status:
Influencers
The following people/items influenced me to apply to Midland Lutheran College.
(Check all that apply).
If you checked other, please explain:
Financial Aid Information
Will you be applying for financial aid?
If yes, please submit the Free Application for Federal Student Aid (FAFSA). 
Are you or either of your parents veterans of the U.S. military?
Convictions
Other than minor traffic offenses, have you ever been convicted of a misdemeanor, felony or other crime?
If yes, please provide an explanation and the approximate dates of each incident:
Optional Information
Responding to the following questions may assist Midland Lutheran College in identifying potential scholarship opportunities for you!
Marital Status:
Religious Affiliation:
What is the name of your hometown church/congregation?
Colleges and universities are asked by many, including the federal government, accrediting associations, college guides, newspapers, and our own college/university communities, to describe the racial/ethnic backgrounds of our students and employees.  In order to respond to these requests, we ask you to answer the following two questions:
What is your ethnicity?
What is your race? (Choose one or more)
Submit Your Application
Social Security #:

I certify that the information given on this application is complete and correct to the best of my knowledge and that I have not attended institutions other than those listed. I understand that I am responsible for arranging for the forwarding of official transcripts from schools I have attended, and that such transcripts become the property of Midland Lutheran College and will not be returned. I understand that I do not have access to confidential recommendations pertinent to the admission decision. I understand that any false or misleading statements may affect my admission decision.

Mailing address for the forwarding of official transcripts:
Office of Admissions
Midland Lutheran College
900 N Clarkson St.
Fremont NE, 68025-4200

Midland Lutheran College Notice of Non-Discrimination

Applicants for admission and employment, students, employees, sources of referral of applicants for admission and employment, and all unions or professional organizations holding collective bargaining or professional agreements with Midland Lutheran College are hereby notified that this institution does not discriminate on the basis of race, color, national origin, gender, age, religion or handicap in admission or access to, or treatment or employment in, its programs and activities.

To submit your application, please click the submit button once. You will receive an email upon submitting the form confirming that the College has received your application.