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online degrees, online degree, certificate programs, life credit degrees, experiential degrees, accredited, continuing education, degrees by self design at Breyer State University

ONLINE APPLICATION FORM

Printable Application Form

Earn your distance learning degrees online today through work & life experience!

Personal Data
Title:
Last name:
First name:
Middle name:
E-mail:
Mailing address:
City:
State/Province:
Zip code:
Country:
Telephone #:
Type of Program Desired
IMPORTANT: To Process your application, You must select the type of program you are interested in:












NOTE: You must choose one of the above in order to process your application.

College Degree Desired
College Degrees:
Complete if "Other" is selected above:
Requested major/minor:
Certificate Desired
Certificate Course Desired:
High School
High School or Equivalency: Yes No
If yes, name of high school:
If yes, year graduated: Example: 1964
College/University
Previous college or university: Yes No
If yes, name(s) of institutions:
If yes, name on transcripts:
If yes, last year attended: Example: 1995
If yes, # credits earned:
SAT or GMAT Score:
Submitting transcripts: Instructions for submitting
Work Experience
Total years employed:
Current occupation:
Current position/title:
Licenses/Certifications:
Resume or Vitae: Instructions for submitting
Method of Payment:
Method of Payment: Electronic Payment Online - Payment Form
Postal Mail
Request Payment Plan: No
Yes
Service Agreement:
Terms of Agreement:
Additional Comments:
Comments:
Note: Please allow up to ten (10) working days to process your application and assessment.

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Breyer State University offers the following programs: