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JSU PAWS (Personal Access to Web Services)

 

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Prospect Information Form

 

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Information

THANK YOU FOR CHOOSING JACKSON STATE UNIVERSITY! 

PLEASE READ THE FOLLOWING BEFORE COMPLETING THE PROSPECT INFORMATION FORM.

•  Please do NOT type name and address in ALL CAPS or in all lowercase .

Please use the correct case.
Example :

CORRECT!

Jane Smith
1400 John R. Lynch Street
Jackson, MS 39217 

  • Please include the State and the Zip/Postal Code in your address.
  • If you are not a resident of Mississippi, please select OUT-OF-STATE RESIDENT for the County Code .
  • For the Phone Number, the first box is for the Area Code ; the second box is for the seven-digit telephone number ; the third box is for the extension , if applicable.

Examples :
CORRECT!

Phone Number: - -

CORRECT!

Phone Number: - -
  • To select more than one choice for Interests or for How I Learned About JSU , press and hold the Ctrl button and select the other choice(s).

Required - indicates a required field.
Future Tiger
U.S. Social Security Number: (999999999 or 999-99-9999)

Name (Do Not Use ALL CAPS)
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Address (Include State & Zip)
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

High School Information
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Prior College Information
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

Gender
Gender:Required Male Female Not Specified

Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White-Caucasian Hispanic Multiracial Other
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian and Other Pacific Islander
White-Caucasian
Hispanic
Multiracial
Other

Birthdate
Date of Birth:Required Month Day Year (YYYY)

Intended Major
Major:

When Do You Plan on Enrolling?
Term of Entry:Required

Interests (Use Ctrl If Needed)
Interests:

How Did You Learn About JSU?
How I Learned About JSU PAWS (Personal Access to Web Services):

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Release: 8.5.4