Application form

Welcome to our online college admissions application, your first step towards becoming a student at SIU.

We took every step to ensure that the process is simple, smooth and straightforward and that you will be finished in less than 15 minutes. All it takes is three simple steps where you will be asked to fill out the form, sign the required documents electronically and pay the $20 processing fee.

And don't worry, you can leave and return to the application as many times as you need, we will save the interim data for you. And if you have any questions you can always call us at 1 (844) 462-9128 or reach us via Live Chat

Personal Information

First Name:^*

Last Name:^*

Country:^*

Street Address:^*

City:^*

Zip Code:^*

State:^*

Home Phone:^*

Cell Phone:

Home Email:^*

Work Email:

Citizenship:^*

SSN:^*

Date of Birth:^*

Gender:^*

Area of Interest

Campus of Interest:

Program of Interest:^*

Degree Type:^*

Specialization:

Start Date:^*

Exp. Grad:^*

Educational Record

High School/GED ^*

Any college attendance?^*

Employment Record

Any employment record?^*

Others

Father’s Name:^*

Occupation:

Mother’s Name^*

Occupation:

Is English Your Primary Language?^*

Ethnicity^*

Show the scholarship application

Payment Entry

Please enter payment information below.
The one-time fee for submitting the application is $20

Credit Card Information

Name (Payer) ^*

Billing Address:^*

Billing Address 2:

City:^*

State:

Country:

Postal Code:^*

Credit Card Number:^*

Credit Card Expiration: ^* /

Card Security Code (CVV):^*

Thank you for applying with Salem University

Congratulations, your application was processed successfully!

Request info

If you want much more than a degree from your continuing education program,
Salem International University can help. Fill out the form below to receive additional information.

Location^*

Program^*

Degree Type ^*

Specialization ^*

First Name^*

Last Name^*

E-mail^*

Phone^* Mobile Regular

State

I acknowledge that, by clicking the Submit button below, as my official signature, I consent to representatives of Salem International University and/or a party representing Salem International University to contact me about educational opportunities via email, text, or phone, including my mobile phone if provided above, using an automatic dialer, or pre-recorded message. Message and data rates may apply. I understand that my consent is not a requirement for enrollment, and that I may withdraw my consent at any time.

Schedule Campus Tour

Whether you’re looking to learn more information about an online or campus degree from Salem International University. Let us help you schedule a campus tour or a call with one of our admissions reps, to walk you through the online process! Schedule a tour Today!

Program^*

Degree Type ^*

Specialization ^*

First Name^*

Last Name^*

E-mail^*

Phone^* Mobile Regular

State

Housing Application

This application does NOT admit you to the University. Application for admissions to Salem International University must be made separately and can be found HERE. Advanced registration and housing deposit must be paid prior to submitting this form.

Personal Information

First ^*

Middle

Last^*

Gender:

Birthday:^*

Email: ^*

Academic Information

Are You a Transfer Student?

Class Standing:

Applying For:

Month

Will you be a student athlete at SIU?

Permanent Address Information

United States or International:

Street Address:^*

City:^*

Zip Code:^*

State:

Country

Home Phone:

Mobile Phone:

Emergency Information (in case of emergency contact)

First^*

Last^*

United States or International:

Street Address:^*

City:^*

Zip Code:^*

State:

Emergency contact phone:^*

Roommate Preferences

Is there someone you already have in mind as a possible roommate? If so, please list the name. We will try to honor you request.

Specific roommate name: (Remember, roommate requests must be mutual. If a roommate is not requested, one will be assigned.)

Are you a smoker ?

Do you object living with a smoker?

When do you go to bed?

Which best describes you?

Would you describe your housekeeping habits as?

What type of music do you like? (Check all that apply)

Country

Hip Hop

Metal

Metal

R&B

Rap

Other

Check the box if you agree with the below statement
I understand that acceptance of this application does not guarantee assignment to a residence hall or admission to the University. I have also read and understand the terms of this application as stated under Residence Halls Policies.
NOTICE: There is a $100.00 non-refundable fee to reserve your room at Salem. You may make this payment using a credit card by calling the Salem Business Office at 304.326.1310 or by sending a check or money order to Salem International University, attn.: Housing, 223 W. Main St., Salem, WV 26426.

Credit Card Information

Name (Payer) ^*

Billing Address:^*

Billing Address 2:

City:^*

Postal Code:^*

State:^*

Country:^*

Credit Card Number:^*

Credit Card Expiration: ^* /

Card Security Code (CVC):^*

Amount: $

Your application and your payment have been accepted

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