+Grad Education Registration Form

This application is for current Asbury Residential Undergraduate students.

An asterisk (*) indicates a required field.

Personal Information

First Name

Preferred Name (if different from First Name)

Middle Name(s)

Last Name

Birthdate

Please select your sex

Female

Male

Country of Citizenship

Do you hold Permanent Resident status in the United States?

Social Security Number (omit dashes):

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 two questions. View definitions.

Are you Hispanic or Latino?

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:

Why did you choose to register for Asbury's +Grad program? You may choose more than one. Hold down the Ctrl key (PC) or the Command key (Mac) then make your selections.

Contact Information

Permanent Address

Country

Street

City

Region

Postal Code

Mobile Phone

Phone Number

Personal Email Address

Asbury Email Address

Academic Information

Other College/University Attended that the Registrar doesn't already know about

When do you plan to graduate from Asbury University with your Bachelor’s Degree?

When will you begin your online Graduate Education program (after having graduated AU)?

Current Major at Asbury University

Which Graduate Education program are you applying for?

References

The Graduate Education program requires Character and Professional References. Please provide the contact information for your references below, and we will email them an electronic reference form to complete for you. References may not be family members.

Character Reference Contact Information

Prefix

First Name

Last Name

Organization

Position/Title

Telephone Number

Email Address

Character Reference's Relationship to You

Waiver of rights to review this Character Reference:

I waive my right to access this report.

I do not waive my right to access this report.

Please sign this reference request electronically.

Professional Reference Contact Information

Prefix

First Name

Last Name

Organization

Position/Title

Telephone Number

Email Address

Professional Reference's Relationship to You

Waiver of rights to review this Professional Reference:

I waive my right to access this report.

I do not waive my right to access this report.

Please sign this reference request electronically.

Personal Statement

Personal Vision Essay (maximum 350 words): Please convey your personal goals and intention for pursuing a Graduate in Education program for your career.

Asbury Community Views

* 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.