Date (required)

First Name (required)

Nickname or Former Name

Middle Initial

Last Name (required)

Address (required)

Country (required)

Birth Date (required)

Home Phone No. (required)

Cell Phone No. (required)

Your Email (required)

Degree Program

Desired starting date

Do you have credits to transfer in?
If yes, please list the institutions from which you will send transcripts for evaluation

Redemption Code (if applicable)

A $100 non-refundable application fee will be assessed for all students. International students will be assessed a $200 non-refundable application fee.