Judson College

DISTANCE LEARNING



 

A COMPLETE application includes ALL of the following:

  1. All information completed below.
  2. $35 non-refundable application fee.
  3. The signature page faxed or mailed to the address at the bottom of this application.
  4. High School/GED/College/University transcripts.
  5. ACT/SAT scores (Education Majors only).
  6. A scanned government-issued ID (driver's license, passport ID page, or other government-issued ID).
  7. A signed copy of the "Condition of Admission" MUST be sent through regular email or may be faxed to 334-683-5147 (scanned and attached to an email as a PDF will also be accepted)

Proposed Date of Entry:
Fall (July 1 - Dec 31)
Spring (Jan 1 - June 30)
Short Term

Proposed Year of Entry:
Proposed Status: Freshman Transfer Early Admission

Personal Data

1. Name:
  Last   First   Middle   Preferred

2. Social Security Number:

3. Date of Birth:

4. Home Mailing Address:
Street, Route, or P.O. Box
City County
State Zip Code Country

5. Phone:   Cell:

6. E-mail:

Information concerning ethnic origin , race, color, religion, national origin, sex, age, disability, or vetaeran status are coolected to comply with federal regulations and compliance reporting. The information will not be used in making decisions about admissions, scholarships, or participation in education programs. Individual information is not reported; it is only provided in aggregate form.

7. Religious Preference:

8. Ethnic Origin

Please select one or more according to your Race:
American Indian/Alaska Native
Asian
Black/African American
Caucasian
Native Hawaiian or Other Pacific Islander
Other

9. Gender:

Male
Female

10. Hispanic:

Yes
No

11. Name of Church:

12. U.S. Citizen?YesNo

I am a permanent resident of :
(If you check the non-resident box above, a notarized copy of your Resident Alien card is required)

13. Veteran: Yes No
If yes, Branch of service

Military Spouse: Yes No

14. Primary Reason for Enrollment My primary reason for enrollment is to seek a degree in:  I am also interested in a minor in:
I expect to be a New Freshman Transfer (less than 24 hours) Transfer (more than 24 hours)

I am not seeking a degree and I want to take courses as a transient student. Course area:

Educational Data

15. List high schools you have attended, beginning with the most recent.

Please give name, location, dates of attendance.

16. Date of High School Graduation (give month and year):

If GED, give the date:

Test Center:
Type of Certificate or Diploma: 
Other: 

17. List the month(s) that you took or plan to take the College Board SAT or ACT and scores earned (give test, month, year, and score.)

18. TRANSFERS: Please list all colleges you have attended. (Please give name, location, and dates of attendance.)

19. Disciplinary/Criminal History

Have you ever been found responsible for a disciplinary violation, academic or behavioral, at a college, university, or other postsecondary institution which resulted in your probation, suspension, removal, dismissal, or expulsion? Yes No




Attach a Photo of Yourself:

Condition of Admission

Judson College students are expected to maintain a high standard of personal conduct at all times which will favorably reflect upon themselves, the Judson community, and the purpose for which the college was founded. I understand and agree that upon admission to Judson College, I will be subject to maintaining these standards and will be subject to all the policies and regulations of the college.

By submitting this form you are aggreeing to the following statement:

I certify that all items of this application are answered correctly and completely. I understand that providing false or incomplete answers may disqualify me from admission to or terminate my enrollment at Judson College. I understand that it is my responsibility to notify Judson College promptly if there is any change in the information prior to my enrollment at Judson College. I further give my high school or college permission to release my official transcript to Judson College.

Judson College complies with applicable laws prohibiting discrimination, including Title VI and VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act, Executive Order 11246, Title IX of the Education Amendments of 1972, Sections 503 and 504 of the Rehabilitation Act of 1972/3, the Vietnam Era Veterans Readjustment Assistance Act, the Age of Discrimination Act of 1975, and the Americans with Disabilities Act of 1990, and does not unlawfully discriminate on the basis of race, color, religion, national origin, sex, age, disability, or veteran status in admission or access to, or treatment or employment in, its programs or services.


(Click here for a printable version)

Judson College
Attn: Distance Learning Office

302 Bibb Street
Marion, AL 36756
(334) 683-5110
(800) 447-9472
Fax (334) 683-5282