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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 the 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
      Office of Admission
      300 W. Seward St.
      Ripon, WI 54971
      Phone: 920-748-8709
      Email: adminfo@ripon.edu
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