CNU Student Application Form

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First Name	*	Last Name	*
Street Address	*
City	*	State	*	Zip Code
Email Address	*	Mobile phone#		Home phone#

Education:
Did you Graduate from high School?		If Yes, enter Month and Year
I will be graduating from high school in:
I am expecting to receive a GED certificate in :			Your names as they appear on high school academic records

College:
College attended if any			How many years of college?
Degree received if any?
Extracurricular activities


Employment:
Current employer if any			Position
Duties			Hours worked per week:

Payment:
Have you set money aside for your education?			Will you be seeking financial assistance?
I will pay for my entire term charges on or before registration	Click for YES		I will provide a letter from an authorized company or agency confirming that they will pay my entire charges each term.	Click for YES

Which programs are you interested in?
Are you a u.s. citizen?			Is English your primary lanuage
When is the best time to contact you?

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