Geneva College

 

 

Application - Higher Education


*Geneva College does not discriminate on the basis of race, color, sex, disability and national or ethnic origin.

Personal Data

Mr Mrs Ms

Last Name

First Name

Middle Name

Other names used at previous colleges

Preferred first name

Home Phone

Cell Phone

Email

Social Security Number

Home address

City

State

Zip

Are you presently employed? Yes No

Job Title/Position

Employer/Organization

Work Address

Work Phone

Will your present employment allow you to fulfill the requirement of 600 hours contextualized educational experience?
Yes    No 

If so, who is your immediate supervisor? 
Previous Education

List all colleges/universities previously attended 
(include Geneva if you attended in the past)

 

First School

Second School

Third School

Name of college

Dates Attended

Major

Degree or # Credits

It has been the historic practice of Geneva College to provide equal opportunity in education and employment without regard to race, color, national or ethnic origins, sex, or handicap.

Honors and Activities

List interests and activities to which you have given a significant amount of time.

List any honors or special recognitions you have received for academic or co-curricular activities.

Optional Section

The following is for reporting purposes and will not be used in the admission process.

Sex:

Male Female 

Birth Date

Religious Affiliation

Marital Status:

Single    Married    Widowed    Divorced/Separated 

Do you identify yourself as a person of Hispanic/Latino origin? Yes  No
Please indicate your race. Check all that apply.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

Are you a U.S. Citizen?

Yes    No 

If no, please provide the following information:

1.Country of Birth

2. Country of Citizenship

3. Immigration Number

Financial Aid

Do you plan to apply for Financial Aid?  Yes No 

The FAFSA form can be accessed at www.fafsa.ed.gov

Are you interested in a graduate assistantship?  Yes No 

Program Choice

I am applying for admission to the:

Accelerated Program

Institutes Program

Self-Directed Program

. . . with a start date of: 

Please submit a 400-500 word essay, typed or word-processed, in which you discuss your motivation for participation in this program in higher education, what your career goals may be, and how this program may aid in meeting those goals. This essay can be sent to hed@geneva.edu


I certify that the information given on this application is complete and correct to the best of my knowledge, and that I have attended no institution other than those listed. I understand that I am responsible for arranging for the forwarding of official transcripts (transcripts marked "Issued to Student" are not official) of records from colleges I have attended, and that such transcripts become the property of the College and will not be returned to me.  Please use the submit button to send application electronically. Thank you.
 


Geneva College admits students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in the administration of its educational policies, admissions policies, scholarships and loan programs, and athletic and other school-administered programs.


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