Race 

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White

I am a U.S. veteran, on active duty, and/or a dependent of a U.S. veteran?

  • Yes
  • No

I am

  • a U.S. Veteran
  • Not a U.S. Veteran

I am

  • on Active Duty
  • not on Active Duty

I am

  • a dependent of a U.S. Veteran who is on Active Duty
  • not a dependent of a U.S. Veteran who is on Active Duty

I am

  • a dependent of a U.S. Veteran who has a service connected injury/illness
  • not a dependent of a U.S. Veteran who has a service connected injury/illness

I am

  • a dependent of a U.S. Veteran who is deceased
  • not a dependent of a U.S. Veteran who is deceased

Do you reside outside of the United States?

  • No
  • Yes

Is your Mailing Address different than your Home Address? - Provide if different than your home address.  Otherwise, skip this section.

  • Yes

If any of these are true, choose Yes.  Otherwise, choose No.

- I have a high school diploma
- I am working toward a high school diploma, and/or
- I have attended college other than Southwestern after high school

  • Yes
  • No
State of Institution Institution - If not listed, choose "School Not Listed." Name of Institution City Degree High school graduation date High school graduation year

I have or am working toward a GED

  • Yes
  • No