NOVA Application

First Name: *

Middle Name:

Last Name: *

Gender:

Male

Female

Other

Prefer not to answer

Email: *

Mailing Address: *

Apt. #:

City: *

State: *

Zip Code: *

Home Phone: *

(e.g. 859-123-4567)

Cell Phone:

(optional)

EKU ID Number: *

Do not include Social Security Number - MUST be EKU ID Number

Number of people living in your home: *

Total, taxable household income range for 2017 (Line 43 on form 1040; Line 27 on form 1040A; Line 6 on form 1040EZ): *

(if there is more than 9 in household, please contact NOVA for guidelines)

What will be your status in the Fall 2019 semester? : *

New student

Current student

Transfer student

Did either of your parents graduate with a bachelor’s degree before your 18th birthday?: *

Yes

No

Are you interested in living in the NOVA Living Learning Community (Sullivan Hall)?: *

Yes

No

Did someone refer you to apply for NOVA?: *

Yes

No

Will you be attending the EKU Richmond campus for Fall 2019?: *

Yes

No

Will you be taking 13 or more credit hours in the Fall of 2019?: *

Yes

No

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Fill out an application if you would like to participate in the NOVA Program.

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