2027-28 Early College Academy Application

To complete your Early College Academy application, you will need to upload a copy of your high school transcript and have a parent or guardian sign in each required section. Please review the application together and ensure all required signatures are complete before submitting.

Student Information:

First Name

Preferred First Name

Last Name

Student's Personal Email Address

Student's Cell Phone

May we text you?

Birthdate

Legal Sex

Social Security Number (optional)

Mailing Address

Country

Street

City

Region

Postal Code

Emergency Contact:

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relationship

Emergency Contact Email

Emergency Contact Phone Number

Academic Information:

Which Early College Academy cohort are you interested in?

Early College Academy Entry Term:

What school do you currently attend?

Please Attach a Copy of your High School Transcript:

Please upload as a PDF

I testify that the infomation given is both thruthful and correct and that I agree to the KU Acceptable Use Policy.

Student Signature:

Click to Sign...

Parent/Guardian Signature:

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Kutztown University Rohrbach Library Laptop/Tablet Policy

Only current Kutztown faculty,staff,and students with a valid KU ID are eligible to checkout a laptop or tablet.
The laptop or tablet can be checked out for 7 days and cannot be renewed.
The laptops and tablets are preloaded with a suite of programs for your convenience. Tampering with University equipment or attempting to access or modify the operating system or any other software or programming, including bypassing security functions, is prohibited.
Late fee of $10 per day will be charged for a laptop or tablet that is not returned on time.
The user is responsible for a lost or damaged laptop or tablet and assumes the cost of replacement or repair. Replacement fees for any lost, stolen, not returned, or damaged beyond repair items will be charged as follows:

Lenovo	MacBook	iPad
Laptop: $1000	Laptop: $2000	iPad with keyboard: $400
Power Cord: $60	Power Cord - $80	Power Cord: $50
Case - $80	Case - $90	Case: $50 Apple Pencil: $100

In order to protect your privacy, anything saved by the user will be deleted when the item is turned off or restarted. Save your work to a USB drive, email account, or other web-based storage account.
The University assumes no responsibility for any damage to the users' personal devices, software, files, and/or equipment.
Laptops and tablets must be used in accordance with University Acceptable Use Policy, Policy ACA-069.

Liability Agreement

This student is responsible for abiding by library policies and returning all library materials on time and in the
condition in which they were borrowed. The parent or guardian listed below is responsible for all fines and
fees incurred by this student. All University policies and procedures including, but not limited to, academic
policies and student discipline policies shall apply.

I am aware that laptops/tablets are checked for any possible damage each time they are
returned, and I accept the responsibility for any possible loss or damage while the student listed
below has it checked out. I agree to the laptop/tablet policy above. I agree to pay all late fees,
replacement fees as listed above in the case of any loss, or costs for repairing a damaged laptop
or tablet.

Student Signature:

Click to Sign...

Parent/Guardian Signature:

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University Relations Office Photography/Video Release Form

The person(s) whose signature appears below agrees to allow his or her child’s photograph(s)/video to be taken and used without monetary compensation for purposes related to publicity and promotion at Kutztown University. The means may include promotional materials, advertisements/publication in newspapers, and publication by electronic means. The photos will be taken solely for university publications, publicity and promotion related to university programs, and KU agrees that it will not distribute the photographs to third parties for any other purposes.

I understand and agree to these terms:

Parent/Guardian Signature:

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Student Signature (if over 18):

Click to Sign...