Judson College

DISTANCE LEARNING



 

A COMPLETE application includes ALL of the following:

  1. All information completed below.
  2. $43 non-refundable application fee.
  3. Your High School/GED/College/University transcripts.
  4. Your ACT/SAT scores (Education Majors only).
  5. A scanned copy of your driver's license, passport ID page, or other government-issued ID.

(Download a printable version of this application here.)


Year:



Expected term of enrollment:
Fall (July 1 - Dec 31)
Spring (Jan 1 - June 30)
Short Term (Education majors only)

Expected Status: Freshman Transfer Transient

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 veteran status are collected 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. Name of Church:

Are you involved in full-time vocational ministry? Yes No

9. Gender:

Male
Female

10. Are you Hispanic/Latino?:

Yes
No

11. 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

12. Are you a U.S. Citizen?YesNo

I am NOT a permanent resident of the U.S.

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. Are you a Veteran or an active service member? Yes No

If yes, what type of military educational benefits will you be using, if any?

14. Are you the dependent or spouse of a veteran or an active service member?
Yes No

Additional Data

15.My primary reason for enrollment is to seek a degree in: 
I am also interested in a minor in:

16. How did you hear about Judson College?

17. What drew you to our online program?

18. What factors in your life make you believe this is a good time to begin an online program that requires discipline and dedication?

19. What challenges can we help you overcome so that you will be successful?

20. Are you interested in receiving financial aid?Yes No

If yes, please complete the FAFSA at www.fafsa.ed.gov. The code for Judson College is 001023.

Educational Data

21. Please complete the following high school information:


If you obtained a GED, please provide the Test Center and Date:


Type of Certificate or Diploma: 
Other: 

22. Please list all colleges and/or universities that you have attended and the dates you attended them:

23. 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

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 as stated in the Judson College Catalog and the Distance Learning Program Student Handbook.

By submitting this form you are agreeing 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 be cause for termination of 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 ethnic origin, 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

302 Bibb Street
Marion, AL 36756
email:distancelearning@judson.edu