Pathway to Success: Summer Start (PaSSS) Application

Contact Information

First Name

Last Name

Street Address (Line 1)

Street Address (Line 2)

City

State or Province

Zip/Postal Code

County

Country

Phone Number

Include area code or country code as appropriate

Email

Other Program Information

Penn State User ID

Must be in the format of: xyz12345

For the next item, refer to this page for a list of undergraduate majors.

Intended Major

If accepted, would you like to live on campus in the summer?

Are you a first-generation college student?

You are considered a first-generation college student if your parents have not graduated from a college or university with a bachelor's degree or higher

Is your ethnicity Hispanic/Latino?

What is your race?

Select one or more

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Is English your first language?

Please explain why you should be selected to particpate in the PaSSS program

Program Requirements Agreement

By entering my first and last name in the box below, I agree to the terms in the Program Requirement Agreement. In addition, I affirm that the information shared on this form is true and correct and I authorize my electronic signature to carry the same weight and legal effect as my written signature.

Electronic Signature

Type first and last name