Application for Admission for Special Status Students

Application Information

I am applying for admission as: *

Post-Baccalaureate

Visitor

Auditor

Other

Applying for semester: *

Applying for year: *

Status:

Full time

Part time (less than 12 hours)

Have you previously applied to or enrolled at Asbury University?:

Yes

No

If so, when did you apply?:

Last year in attendance?:

Your Information

Gender: *

Male

Female

First name: *

Middle name:

Last name: *

Preferred first name:

Street address: *

City: *

State: *

Zip code: *

County (Ky. residents only):

Home phone: *

Cell phone:

Email address: *

Birthdate: *

Country of citizenship: *

Type of visa (if not a US citizen or permanent resident):

Citizenship: *

Ethnicity (optional):

Marital status:

Spouse's name:

Spouse's Citizenship:

Are you an employee or a dependent of an employee of:

One Macklem Drive • Wilmore, Ky 40390 • 1-800-888-1818
KY Campus: (859) 858-3511 • FL Campus: (407) 482-7620