The WUE Online application does not substitute for the Admissions Application to Portland State University. For further information about admissions, check out Undergraduate Admissions.

Personal Information
First Name
Middle Name
Last Name
Date of birth [mm/dd/yy]
Place of Birth [City]
Place of Birth [State/Province]
Country of Citizenship
If not USA, type of Visa/other
Address Information
Current Address
City
State
Postal Code
Permanent Address [If different then Address above]
City
State
Postal Code
Daytime Telephone
Alternate Phone
E-mail Address

Do you hold permanent or temporary resident immigration status?
Yes
No

Do you hold Refugee or Political Asylum Status?
Yes
No

[If you answered yes to either of the above, you must send a copy of both sides of Resident alien
Card or Form 1-94 or other documentation via fax: 503-725-5595 Attn: Linda Etter, WUE Coordinator.]
Length of residency in your present state:

From [mm/dd/yy]: To [mm/dd/yy]: State:

Education Information
Planned term of Admission: [choose one only]	Year: Fall Winter Spring Summer
Select the Program: [Please check one]	Applied linguistics Biomedical Informatics Black Studies Child and Family Studies Civil Engineering Community Development Computer Engineering Computer Science Criminology and Criminal Justice Economics Electrical Engineering Environmental Engineering Environmental Sciences Environmental Studies Film Geography Geology Health Studies History International Studies Mathematics Mechanical Engineering Music Philosophy Physics Speech and Hearing Sciences Theater Arts Women's Studies University Honors Program

Have you attended Portland State University previously?
Yes
No

Have you ever before received tuition benefits from a Western Exchange Scholarship?
Yes
No

[If Yes]

Name of College or University:

Term:

Year:

Have you paid non-resident tuition at PSU during the past year?
Yes
No

[If Yes] Term(s):

List all colleges and Universities attended, include your reset institution: [List most recent first]

School	State	From [mm/yy]	To [mm/yy]

Parental Information

[Note: If you are 25 years of age or older, it is not required that you complete this section.]

*Father information*
First Name
Middle Name
Last Name
Address
City
State
Postal Code
Is your Father:	Living Deceased

If father resides in home state, when did his present stay begin?

[mm/dd/yy]:

Mother information
First Name
Middle Name
Last Name
Address
City
State
Postal Code
Is your Mother:	Living Deceased

If Mother resides in home state, when did her present stay begin?

[mm/dd/yy]:

Is either parent or legal guardian Currently on Active Duty in the armed services of the United States of America?
Yes
No

If your parents are divorced, which parent was designated by the court as your custodian?
Father
Mother

[If someone other then your father or mother has been designated your legal guardian
by a court order, you must send a copy of the order and state the name and adress
of the designated guardian via fax: 503-725-5595 Attn: Linda Etter, WUE Coordinator.]