Early Warrior Dual Enrollment Application

Please fill out the form below using the student's name, contact information and preferences.
Please note that all fields marked with an asterisk (*) are required for the submission of the form.

Enrollment Deadline: Spring 2025 - December 9th

Student's Biographic Information*

First Name*

Middle Name

Last Name*

Birthdate*

Gender

Social Security Number*

Student's Contact Information

Mailing Address*

Country

Street

City

Region

Postal Code

Primary Phone Number*

Email Address*

Academic Information

Desired Semester/s*

Academic Interest/Course of Study*

How many courses do you intend on taking?*

High School*

Have you previously attended Lycoming College?

Yes

No

Does a member of your family currently work at Lycoming College?

Yes

No

Is there any additional information that you would like to add to this application?

Additional Information

Additional Questions?

If you have any further questions about becoming a student at Lycoming College through the Early Warrior Dual Enrollment program, please refer to our website or contact the Office of Admissions at admissions@lycoming.edu for more information.

Thank you for your interest!