Graduate Education Application

Personal Information

Prefix

* First Name:

Middle Name:

* Last Name:

Preferred Name:

* Birthdate:

* Please select your sex:

Female

Male

Other last names used (including maiden name)

Citizenship Information

* Please select your primary citizenship:

Citizenship:

Residency Status:

U.S. Permanent Resident

* Please enter your Social Security Number (omit dashes):

In order for Asbury to report 1098-T tax information to the IRS, your correct U.S. tax identification number - either a U.S. Social Security Number (SSN) or U.S. Individual Tax Identification Number (ITIN) - is required.

Privacy Protection Policy:

We are committed to protecting your privacy.

Upon receiving the secure transmission of your Social Security Number, it is immediately encrypted. Only the last 4 digits of your Social Security Number is available in plaintext for identification and account matching purposes. Your Social Security Number is available for decryption only by those officials who oversee the automated loading of personal information into student information systems, and only for that limited purpose.

Our databases are actively monitored and are firewalled to ensure the protection of your personal information, and we employ all industry-standard safeguards.

SSN:

Please select your race/ethnicity (optional):

Colleges and universities are asked by many groups, including the federal government, accrediting associations, college guides, and newspapers, to describe the ethnic/racial backgrounds of their students and employees. In order to respond to these requests, we ask you to answer the following questions.

View Definitions

Are you Hispanic or Latino?

Yes

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Have you served in the US military?

Contact Information

* Permanent Address:

Country

Street

City

Region

Postal Code

* Is your Mailing Address the same as your Permanent Address?

* Mailing Address:

Country

Street

City

Region

Postal Code

* Phone Number:

Mobile Phone:

* Email Address:

Employer Information

* What is your current place of employment?

* What is your current job title?

* Please provide a brief job description.

Academic Information

* Please select your highest level of education:

* Have you previously attended Asbury University? (Select the highest level that applies.)

* I last attended AU in this year (YYYY):

Name used during most recent AU enrollment:

Please type a brief rationale for why you want to return to Asbury University. You may wish to include your reasons for leaving, your progress while away from the University, and any changes in your life that will position you for success in your return to college.

DeleteSchool _ID_
Other Colleges/Universities Attended
Institution attended: Hidden: College CEEB Level of study at the above institution:

Add School

Character Reference Contact Information

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Prefix:

* First Name:

* Last Name:

Organization:

Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Character Reference:

Yes

* Your Signature:

Employer Reference Contact Information

Supervisor/Education Agency Representative Reference

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Supervisor or Education Agency Representative Reference Contact Information--You may choose which one.

Prefix:

* First Name:

* Last Name:

* Organization:

* Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Employer Reference:

Yes

* Your Signature:

Colleague Reference Contact Information

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Prefix:

* First Name:

* Last Name:

* Organization:

* Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Colleague Reference:

Yes

* Your Signature:

Principal Reference Contact Information

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Prefix:

* First Name:

* Last Name:

* Organization:

* Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Principal Reference:

Yes

* Your Signature:

Professional Reference Contact Information

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Prefix:

* First Name:

* Last Name:

* Organization:

* Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Professional Reference:

Yes

* Your Signature:

Superintendent or Master of Arts Professor Reference Contact Information--You may choose which one.

Please provide contact information for your reference below, and we will email them an electronic form to complete for you. References may not be family members.

Superintendent/MA Professor Choice

Prefix:

* First Name:

* Last Name:

* Organization:

* Position/Title:

* Telephone Number:

* Email Address:

* Relationship:

* Waiver of rights to review Superintendent/MA Professor Reference:

Yes

* Your Signature:

Community Life Affirmation

* All the information contained on this application is true and correct to the best of my knowledge. I understand that I am responsible for arranging the forwarding of official transcripts of all schools I have attended or am attending and official test scores as required. Such documents become the property of Asbury University and will not be returned to me. Also,

Asbury University cultivates a Christ-centered community that is committed to whole person development, earnest discipleship, critical thinking, service and care for others. Asbury University is a community that abstains from alcohol as a testimony against the injustice and addiction which can come from the use of alcohol and suppots our witness to be a holy people set apart for God. In addition, Asbury University holds a traditional, orthodox view regarding sexuality and marriage. For more information, read the AU Sexuality Statement here. You may read our Community Life principles that shape our community here.

I agree to:

Abstain from sexual behavior outside of marriage between one man and one woman.
Respect Asbury's tradition in regard to alcohol by refraining from drunkenness and avoiding illegal drugs, marijuana, and other controlled substances not prescribed to me. Alcohol use of any kind should not occur at any Asbury University class (in person or online) or other official Asbury University events.
Respect the Community Life principles and recognize that my faculty members and other AU staff and students may challenge and encourage me in whole person development in these ways.

Abstain from sexual behavior outside of marriage between one man and one woman.
Respect Asbury's tradition in regard to alcohol by refraining from drunkenness and avoiding illegal drugs, marijuana, and other controlled substances not prescribed to me. Alcohol use of any kind should not occur at any Asbury University class (in person or online) or other official Asbury University events.
Respect the Community Life principles and recognize that my faculty members and other AU staff and students may challenge and encourage me in whole person development in these ways.

Yes, I agree and will follow the Community Standards.

* Please type your full name to verify your agreement to both of these statements:

Asbury University does not discriminate on the basis of race, color, gender, age, national or ethnic origin, or disability in the admission of students, educational policies and programs, employment policies, and activities. In addition, Asbury University does not discriminate on the basis of religion in the admission of students and student access to educational programs.