Social Security / Identification#:

Salutation:	Mr. Mrs. Miss Ms.
First Name:
Middle Name:
Last Name:
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Permanent Address:	(In your country of citizenship)
Home Phone:	Email Address:
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Sex:	Male Female
Date of Birth:	(mm/dd/yyyy)

Year of Graduation:

Program of Study

 I am applying for admission in August January Other for the year of  .

I plan to enroll

Full time

Part time

I plan to enroll as	Freshman	Transfer	Re-admit
Definition of terms used.	Employee	Rising Senior	Visiting
	Graduate

I intend to earn a	Bachelor of Arts Degree	Associate in Arts Degree
No Degree

Check Off Your Intended Major/Sports Program
(Check all that apply)

Bachelor of Arts Degree Programs

Accounting	American Studies
Art	Art Education
Biology	Business Administration
Christian Ministries	Communications/Journalism
Edu-Elementary: P-5	Edu-Middle School: 5-9
Edu-High School: 8-12	English
History	Humanities
Human Services	Mathematics
Physical Education	Psychology
Social Science	Undecided

Pre-Professional Programs

Allied Health (Physical Therapy,   Occupational Therapy, Nursing, etc.	Dentistry
Law	Medicine
Ministry	Pharmacy
Physical Therapy	Veterinary Medicine

Athletic Programs

Baseball	Basketball
Bowling	Cheerleading
Cross Country/Track	Golf
Mountain Biking/Road Racing	Soccer
Softball	Tennis
Volleyball