A COMPLETE application includes ALL of the following:
2. Social Security Number:
3. Date of Birth:
4. Home Mailing Address: Street, Route, or P.O. Box City
Zip Code Country
5. Phone: Cell:
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
Native Hawaiian or Other Pacific Islander
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)
If yes, Branch of service
Select Your Service
Military Spouse: Yes No
14. Primary Reason for Enrollment
My primary reason for enrollment is to seek a degree in:
General Social Studies
Bachelor of Ministry
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.
15. List high schools you have attended, beginning with the
Please give name, location, dates of attendance.
16. Date of High School Graduation (give month and year):
If GED, give the date:
Type of Certificate or Diploma:
Standard HS Diploma
Advanced HS Diploma
Certificate of Attendance/Completion
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
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.
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.
Judson College Attn: Distance Learning Office