Professional Documents
Culture Documents
Year
_________________________________________________________________
First Name
Middle Initial
Last Name
___________________
_________________________________________________________________
Address: Number & Street
___________________
Apartment/Unit
_________________________________________________________________
Address: City
State/Province
Postal Code
___________________
Country
_________________________________________________________________
Home Phone
Preferred?
Cell Phone
Email Address
Preferred?
Do you plan to
enroll as a full-time student?
live on campus?
apply for financial aid?
Yes
Yes
Yes
No
No
No
Church Information
Gender:
Citizenship:
Male
Female
US Citizen
Permanent US Resident
Non-US Citizen
Name: _____________________________________________
City: ______________________________________________
State/Province: ______________________________________
Weekly
Denomination: ______________________________________
Monthly
Rarely
Azusa Pacific University is an institution built on Four Cornerstones, which define why APU exists:
Christ (God First since 1899!)
Transformational Scholarship (strong academic programs that develop your character and prepare you for your future)
Life-giving Community (a campus environment that encourages involvement and dynamic relationships)
Sacrificial Service (a culture of serving others and giving of yourself)
Are you readily willing to embrace these Four Cornerstones as you consider the educational, social, and spiritual
environment at Azusa Pacific University?
Definitely
Unsure (Please contact me for details)
Not at this point
Have you ever been found guilty, or responsible for,
any criminal or military offense, excluding minor
traffic violations, either as a juvenile or an adult?
Yes
No
No
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_____________________________________________
College Name
From
_____________________________________________
College Name
College Name
College Name
College Name
(mm/yyyy)
______________
To (mm/yyyy)
Credits Completed
(mm/yyyy)
______________
To (mm/yyyy)
Credits Completed
(mm/yyyy)
______________
To (mm/yyyy)
Credits Completed
_____________________
From
_____________________________________________
Credits Completed
_____________________
From
_____________________________________________
______________
To (mm/yyyy)
_____________________
From
_____________________________________________
(mm/yyyy)
_____________________
From
_____________________________________________
College Name
_____________________
(mm/yyyy)
______________
To (mm/yyyy)
Credits Completed
_____________________
From
(mm/yyyy)
______________
To (mm/yyyy)
Credits Completed
Please indicate the academic major you plan to study at APU: ________________________________________________
Please sign below, indicating that you understand and agree to the following:
Re-enrolling is an application process and I must be re-admitted to the university before I may enroll in classes.
I must have a zero balance on my APU account and have no defaulted loans before I can be re-admitted.
I understand that if I have been away for more than two semesters I will be subject to new catalog requirements.
If I have attended any other schools in my time away from Azusa Pacific University, I must submit official transcripts
from each school attended.
I must receive clearance from the offices of Student Life, Student Financial Services, and Residence Life. The Office of
Undergraduate Admissions will contact these offices for clearances on my behalf.
I understand that if I have filed an Intent to Graduate form and have been away from Azusa Pacific University for more
than two years, I am no longer under the same catalog and therefore, may need additional requirements to complete my
degree.
Upon re-admission to the university, my academic record will be evaluated by the Office of the Undergraduate
Registrar in order to determine the remaining units/requirements needed to fulfill degree requirements.
I certify that the information in my application is complete and correct to the best of my knowledge. If my application
is accepted, I agree to abide by the policies, standards, and regulations at Azusa Pacific University and respect the
ideals, principles, and traditions it upholds as a Christian institution of higher learning. I further understand that this
information will be relied upon by the officials of the university in determining my admission status and that the
submission of false information is grounds for rejection of my application, withdrawal of an offer of acceptance,
dismissal from the university, revocation of a degree, and/or other disciplinary action.
_________________________________________________________________
___________________
Signature
Date
Office of Undergraduate Admissions Azusa Pacific University PO Box 7000 Azusa, CA 91702
Phone: (626) 812-3016 Fax: (626) 812-3096 Email: admissions@apu.edu
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