Special Member Affiliation Form

The Office of Admission at Hampton University looks forward to reviewing your application for admission. Please use this form to self-identify as an active member of Jack & Jill of America, Inc., Boy Scout - Eagle Scout, Girl Scouts - Gold Scout, or 100+ Black Men of America. Only students applying for Fall 2025 should submit this form.

The Office of Admission welcomes applications for first-year and transfer admission. The University seeks students destined to become future leaders in their chosen professions, whether in the arts, business, education, engineering, health, journalism, law, medicine or the sciences. In addition, the University welcomes students who believe in honesty, integrity, respect for self and others, take responsibility for their actions and are seeking opportunities to enhance the development of their character. In reviewing applications for the right fit, the University takes a holistic approach focusing on overall academic achievement, characteristics that demonstrate leadership potential and personal qualities indicative of the highest ethical values.

First Name

Middle Name

Last Name

Birthdate

Email Address

Application Type

Mailing Address

Country

Street

City

Region

Postal Code

Member Affiliation