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Tiffiin/Lourdes Education Application
We are excited you are interested in taking classes through this unique partnership.
Please complete and submit the form below so that we can move forward with the course registration process.
Thank you
Welcome to the Lourdes Partnership Application page!
Please complete and submit this application when requested
by the Tiffin Undergraduate Education Program.
For questions, contact the Admissions office at 419-517-8908 or
l
uadmits@lourdes.edu
*All questions with an asterisk (*) are required.
Personal Information
*First Name
*Last Name
*Email
*Mobile
*Birthdate
*Birthdate
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Gender
Female
Male
*SSN
Mailing Address
*Permanent Address
*Permanent Address
Country
Street
City
Region
Postal Code
Ethnicity
Are you Hispanic or Latino?
Are you Hispanic or Latino?
Yes
No
Please select your race(s). (Please choose all that apply)
American Indian or Alaska Native
Asian
Black or African American
Hispanic
Native Hawaiian or Other Pacific
White
Academic Information
*Intended Start Term (Fall start term is August / Spring start term is January / Summer start term is May)
Fall 2025
Fall 2026
Spring 2026
Summer 2026
*What is your intended program of study?
Adolescent to Young Adult (AYA) (Tiffin Students Only)
Middle Childhood (MDL) (Tiffin Students Only)
Student Type
New First Time Freshman
Transfer
Re-Admit
Student Level
Undergraduate
Certification
Do you certify the following?* I certify that all of the information submitted in the application is my own work, factually true, and honestly presented. I authorize all schools attended to release all requested records and authorize review of my application. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false. I understand that an offer of admission is conditional, pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based.
Do you certify the following?* I certify that all of the information submitted in the application is my own work, factually true, and honestly presented. I authorize all schools attended to release all requested records and authorize review of my application. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false. I understand that an offer of admission is conditional, pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based.
Yes
No
Please affirm the following before you submit your application.
I agree to abide by the Community Standards Code Policy, available on the Lourdes University website (https://www.lourdes.edu/campus-life/public-safety/community-standards-student-conduct/community-standards-code-policy/). I also authorize the release of grades earned at Lourdes University to Tiffin University.
By adding my full given name below, I verify the above information to be true and accurate to the best of my knowledge.
Round
Tiffin 2025
Generate Pin
Yes
Round Always Create
Yes
Submitted Flag
Yes
Submit