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Ripon College
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    Ripon College Self-Identification Form

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    Thank you for taking a moment to complete our Self-Identification Form.
    • While we may have some of this information on record, please answer these questions in their entirety as we know personal and family circumstances may change over time.
    • If you have questions about this form or have personal information you'd like to discuss privately, please contact Lisa Zeman at zemanl@ripon.edu.
    Student information
    Birthdate
    Birthdate
    Contact information
    Mailing Address
    Mailing Address
    Student identification information
    Are you a citizen, national, or permanent resident of the United States?
    Are you a citizen, national, or permanent resident of the United States?
    Ethnicity (Select one or more)
    Ethnicity (Select one or more)
    Hispanic/Latino
    Hispanic/Latino
    Academic information
    When you start your Ripon College experience, what student year will you be joining?
    When you start your Ripon College experience, what student year will you be joining?
    Are you a transfer student?
    Are you a transfer student?
    Parent information
    First Parent/Guardian
    Did your first parent/guardian earn a bachelor's degree or graduate from a four year college or university?
    Did your first parent/guardian earn a bachelor's degree or graduate from a four year college or university?
    Second Parent/Guardian
    Did your second parent/guardian earn a bachelor's degree or graduate from a four year college or university?
    Did your second parent/guardian earn a bachelor's degree or graduate from a four year college or university?
    Additional Family Information
    Disability information
    Students who have a disability may be eligible for services to assist them with their educational needs. Please answer the following questions so we can best serve you during your college experience:
    Do you have a physical disability?
    Do you have a physical disability?
    Do you have a learning disability (and/or Attention Deficit Disorder?)
    Do you have a learning disability (and/or Attention Deficit Disorder?)
    Signature
    Today's date
    Today's date
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    Ripon College
    300 W. Seward St.
    Ripon, WI 54971
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