| Section I - General Student Information |
| *Applying For Semester: |
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| * Do You intend to fulfill the core requirements for the Urban Semester Program while studying in Philly? |
Yes
No |
| * Are you a participant in the Messiah College Honors Program? |
Yes
No |
| *Please Select One: |
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| *Applicant Name: |
First | Middle Initial | Last |
| *Gender: |
Male
Female |
MCID#:
(for Messiah students only) |
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PO Box#:
(for Messiah students only) |
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| *Social Security #: |
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| *Birth Date : |
(Use xx/xx/xx format) |
Campus Phone #:
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(Use xxx-xxx-xxxx format) |
| *Email Address You Use Most Often: |
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| *Major: |
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| Secondary Major: |
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| Minor: |
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*Name of Advisor:
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First | Last |
| *Year of Planned Graduation: |
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| *Current Class Standing |
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| Section II - Student Addresses |
It is very important that the Philadelphia staff be able to contact you between the time you apply and the time you move to Philadelphia.
Please complete this address section carefully and completely, giving any interim address where you can be reached until the beginning of next semester and the dates during which you can be reached at each address.
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| Current Campus Address |
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| Residence Hall & Room No. |
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| Street or Rural Route: |
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| City: |
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| State: |
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| Zip Code: |
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Permanent Home Address |
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| Street/ Rural Route/ PO Box/ Apt: |
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| City: |
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| State: |
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| Zip Code: |
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Telephone Number:
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(Use xxx-xxx-xxxx format) |
| Name of Parent or Guardian: |
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Interim Address |
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| Street/ Rural Route/ PO Box/ Apt: |
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| City: |
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| State: |
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| Zip Code: |
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Telephone Number:
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(Use xxx-xxx-xxxx format) |
Dates at this Address:
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From:
To:
(Use xx/xx/xx format) |
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| Section III - Student Demographic Information |
| *Ethnic Background: |
American Indian/ Alaskan Native
Black/ Not of Hispanic origin
Asian or Pacific Islander
White/ Not of Hispanic origin
Other:
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| *Marital Status: |
Divorced
Separated
Widowed
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Married
Single |
| *Religious Background: |
Catholic
Greek Orthodox
Jewish
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Protestant
None
Other
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| *Were you a full time resident of Pennsylvania prior to enrollment at your college? |
Yes
No |
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| Section IV - Application Questions |
*List campus organizations in which you have been active
including hobbies, talents or areas of interest:
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*List any special requirements (dietary, medical, access, etc..)
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| At Messiah College Philadelphia Campus (MCPC) we see ourselves as a Learning Community that is truly unique. Your education will not simply take place within the four walls of the classroom, but involve learning experiences that extend out into a major university, the surrounding neighborhood, and even the larger city itself. Through active engagement with people in North Central Philadelphia and at Temple University, the city becomes your text and context for learning, living, and service. With this in mind, please respond to the following questions: |
*1) Have you been involved in other learning communities like MC-PC? If so, what was the experience like? If not, what are you hoping to receive from your participation in this learning community?
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*2) At MCPC we are committed to having our classroom discussion, readings, assignments and lectures tied to community involvement and the surrounding community setting. How do you plan to participate in this type of experiential education and what do you hope to learn from it?
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*3) Reflect and write some of your thoughts regarding your attitude toward the city. How do you currently define/describe urban culture?
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*4) What are some of the educational goals you hope to achieve in your time at MCPC? What kinds of activities do you think would help your pursue these goals?
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