Graduate Application – RESURRECTION POWER UNIVERSITY

Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Emergency Contact

Name *

First

Last

Relationship to applicant

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Universities that are recipients of federal dollars are required by the Federal government to solicit certain demographic information to meet federal reporting requirements. Applications are requested to provide the following information voluntarily. This information will not be utilized in a discriminatory manner.

Nation of Citizenship

Race / Origin

Native Language

Religion

Gender

Date of Birth: Month and Year

This application is for enrollment as:

Areas of Study

What is your planned degree program?

Expected Graduation Date

If your records have been expunged pursuant to applicable law, you are not required to answer yes to the following questions. If you are unsure whether to answer yes, we strongly suggest that you answer yes and fully disclose all incidents to avoid any risk of disciplinary action or revocation of your offer of admission.

Education Information

What is your highest degree, subject are, and date of graduation

List all the postsecondary schools you have attended, degrees, and graduation dates

Address Line 1

Address Line 2

City

State

Zip Code

If you attended more than one postsecondary institution, list the rest here.

Attach copies of your resume, transcripts, degrees, and certificates from of all postsecondary institutions you have attended.

Please provide the names of people in your immediate family who have attended the University.

Name

First

Last

Relationship

Name

First

Last

Relationship

Extracurricular, Personal and Volunteer Activities

Extracurricular Activities

List your organizations, position, description of the activity, and hours per week of involvement.

Talents and Awards

List each, a description, the level, and number of years of involvement.

Community Service Work

List the type of work, your role, and hours per week of involvement.

Employment

List the job, your title, description, hours per week, and dates of employment.

Agreement

I understand that this application is for admission only for the term indicated. I agree that I am bound by the University’s regulations concerning application deadlines and admission requirements. I agree to the release of any transcripts and test scores to this institution, including any SAT, Achievement Test, and ACT score reports. I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application or residency statement will result in disciplinary action, denial of admission and invalidation of credit or degrees earned. If admitted, I agree to abide by the policies of the Board of Regents and the rules and regulations of the University. Should any information change prior to my entry into the University, I will notify the Office of Admissions. I understand that the application fee I submit with this application is a non-refundable fee.

Do you understand and agree to the terms listed above? *

Yes, I understand and agree to the terms listed above.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Date / Time

Date

Time