ONLINE APPLICATION FORM

Earn your distance degrees online today!

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
Career 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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