APPLICATION FOR LPC/ELN ONLINE COHORT STUDENTS
APPLICATION FOR LPC/ELN ONLINE COHORT STUDENTS THIS APPLICATION IS FOR PARTICIPANTS IN A CERTIFIED ELN WHO WANT TO ENROLL IN LPC COURSES AS A NONDEGREE SEEKING STUDENT THROUGH THE LPC/ELN ONLINE COHORT PROGRAM. Life Pacific College
! Fall Term
Applying to take courses in Semester: 20
! Spring Term
I. PERSONAL DATA Full Legal Name: Last
First
Middle
Address
City
Home Phone
Cell Phone
Previous Name
State
Zip
Email Address Social Security Number
Date of Birth
Country of Citizenship
Birthplace
If not U.S. citizen, what type of visa do you hold?
Exp. Date
Ethnic Background: (Please check one or more) ! White, Non-Hispanic ! Asian
! Black, Non-Hispanic ! Native Hawaiian/Pacific Islander ! Other
! Native American/Alaska Native ! Hispanic, Spanish origin, or Latino
Life Pacific College does not discriminate in its admission policies on the basis of race, color, national origin, gender, age, disability, status as a veteran, or any other characteristic protected by law.
Marital Status: !Single
!Engaged
!Married
!Separated
!Divorced
!Widowed
!Remarried
II. EDUCATIONAL DATA High School last attended
Date of Graduation
High School GPA
Have you ever enrolled in courses with LPC?
! Yes
! No
If yes, when? Name of College or University 1.
Dates Attended
Major Field of study
Earned Diploma or degree
2.
III. RELIGIOUS DATA When did you receive Jesus Christ as your personal Savior?
Where?
How long have you consistently walked with the Lord? Have you received the baptism of the Holy Spirit?
!Yes
(years) and/or !No
(months)
If yes, when?
If not, what is your attitude concerning this experience? Name and location of the ELN you are attending Address Church affiliated with the ELN
City
State
Zip
IV. Additional Items Include with this application: •
A minimum one page typed essay describing your personal history, salvation experience, and what you believe concerning your Christian faith. Pay attention to grammar and spelling as this essay will also be used to assess your writing ability to succeed in college-level courses.
•
The completed LPC/ELN Online Cohort College Readiness Self-Assessment
•
A course enrollment form identifying which course/s you are planning to enroll in this term.
•
The Student Information Release Authorization if you would like to allow LPC to disclose enrollment status and grades to your ELN Leader (optional).
I hereby apply for admission to Life Pacific College and certify that to the best of my knowledge the information given in this form is true. I understand that my file may be made available to any faculty member or administrative office of LIFE PACIFIC COLLEGE.
Date
Signature Please mail this form to:
LIFE PACIFIC COLLEGE Admissions Office (Attn: ELN Liaison) 1100 Covina Blvd. San Dimas, CA 91773 877.886.5433 toll free 909.706.3070 fax [email protected] For Office Use Only
! Approved
! Denied
! Notified
LPC/ELN ONLINE COHORT College Readiness Self-Assessment Questions The following self-assessment is intended to assist you in evaluating your readiness for college-level courses. On a scale of 1-5, choose the answer that best matches your current study habits and approach to learning. Answer the questions as honestly as you can, as this will provide you with the most accurate feedback. Be sure to include this assessment with your application. Personal Goals: 1.
Can you clearly state why you are interested in taking college courses while participating in your ELN?
No 2.
2
3
4
5
Yes
5
Yes
Are you confident that you can succeed in college work?
No 3.
1
1
2
3
4
Are you planning on completing a college degree in the future?
No
1
2
3
4
5
Yes
4
5
Yes
4. Are you in control of your own success or failure?
No
1
2
3
5. When you encounter a challenging problem, do you try to solve it?
No
1
2
3
4
5
Yes
Time Management: 6.
Are you good at setting goals and deadlines for yourself and meeting them?
No 7.
1
2
3
4
5
Are you organized? Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298
!
Yes
No 8.
2
3
4
5
Yes
3
4
5
Yes
4
5
Yes
Do you keep yourself on track and on time?
No 9.
1
1
2
Do you persevere when things become difficult?
No
1
2
3
10. Are you able to spend 8-10 hours each week on an online course?
No
1
2
3
4
5
Yes
11. Do you feel that you have enough time for school and your ELN commitments?
No
1
2
3
4
5
Yes
Study Skills: 12. Are you able install software and updates, as well as upload, download, and manage files on a computer?
No
1
2
3
4
5
Yes
13. Do you regularly use the Internet to do basic research and manage email?
No
1
2
3
4
5
Yes
14. Are you able to learn new concepts and ideas, either by reading assigned materials or by conducting your own research?
No
1
2
3
4
5
Yes
15. Do you try to get the meaning of new words as you see them for the first time?
No
1
2
3
4
5
Yes
3
4
5
Yes
16. Do you look for the main ideas as you read?
No
1
2
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
17. Can you read up to 100 pages in a week per course?
No
1
2
3
4
5
Yes
18. Can you clearly summarize a college-level reading assignment?
No
1
2
3
4
5
Yes
4
5
Yes
19. Are you comfortable forming a thesis statement?
No
1
2
3
20. Can you write a paper of 5 or more organized pages that refers to two or more sources?
No
1
2
3
4
5
Yes
5
Yes
21. Are you comfortable integrating research into your essays?
No
1
2
3
4
Assessment results
This assessment is meant to be a guide for evaluating your own college preparedness. It is not a precise measurement of your likelihood of college success, but rather a starting point for discussion about your academic readiness and needs. Categories resulting in higher scores indicate a readiness to begin college coursework, while lower scores may indicate areas of individual growth. Consider reviewing your assessment results with your ELN leader in order to determine the best course of action for you. Scoring To calculate your total score, add the individual scores from each of your above answers. Total score: _________ Score 1-35: There are quite a few areas in which you may need some growth before you are ready for college-level learning. Consider reviewing your assessment with your ELN Director to explore how best to proceed.
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
Score 36-70: There are a few areas in which you may need some growth prior to beginning college-level courses. Assess your growth-areas by identifying the lower-scoring answers on this self-assessment, and consider possibilities for strengthening these areas before and during your college-learning experience. Score over 70: You are well-prepared for college-level learning. Though you seem well-equipped for college-level courses, use this self-assessment to help you identify areas which you could strengthen or further develop in order to do well academically.
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
Please send this order to Life Pacific College ELN Liaison 1100 Covina Blvd San Dimas, CA 91773-3298
LPC/ELN ONLINE COHORT COURSE ENROLLMENT !Check if new address Full legal name (first middle last)
! Miss
! Mrs
Toll free 877.886.5433 Fax 909.706.3099 [email protected]
! Mr
Date Date of Birth
Address City
State
Zip
Phone Email ELN Student Signature _________________________________________________________________________________________
Online LPC/ELN Courses
Units
Cost
Year 1: Fall Courses ! Gm118 Faith for Life ! Bi113 Intro to Biblical Literature Total
3 3
$200 $200
Year 2: Fall Courses ! Ev210 Spiritual Gifts & Evangelism ! So131 Cultures of Ancient Civilizations Total
3 3
$200 $200
Year 1: Spring Courses ! Ev110 Multicultural Evangelism ! Bi101 Pentateuch Total
3 3
$200 $200
Year 2: Spring Courses ! Bi216 Synoptic Gospels ! So230 Marriage & Family Total
3 3
$200 $200
For Office Use: Course
Total
Office use: ! AP ! ED ! BN ! Paid ! Enrolled ! Phone ! Email ! Moodle ! Registrar___________
! Fall Term
Applying to take courses in Semester: 20
! Spring Term
I. PERSONAL DATA Full Legal Name: Last
First
Middle
Address
City
Home Phone
Cell Phone
Previous Name
State
Zip
Email Address Social Security Number
Date of Birth
Country of Citizenship
Birthplace
If not U.S. citizen, what type of visa do you hold?
Exp. Date
Ethnic Background: (Please check one or more) ! White, Non-Hispanic ! Asian
! Black, Non-Hispanic ! Native Hawaiian/Pacific Islander ! Other
! Native American/Alaska Native ! Hispanic, Spanish origin, or Latino
Life Pacific College does not discriminate in its admission policies on the basis of race, color, national origin, gender, age, disability, status as a veteran, or any other characteristic protected by law.
Marital Status: !Single
!Engaged
!Married
!Separated
!Divorced
!Widowed
!Remarried
II. EDUCATIONAL DATA High School last attended
Date of Graduation
High School GPA
Have you ever enrolled in courses with LPC?
! Yes
! No
If yes, when? Name of College or University 1.
Dates Attended
Major Field of study
Earned Diploma or degree
2.
III. RELIGIOUS DATA When did you receive Jesus Christ as your personal Savior?
Where?
How long have you consistently walked with the Lord? Have you received the baptism of the Holy Spirit?
!Yes
(years) and/or !No
(months)
If yes, when?
If not, what is your attitude concerning this experience? Name and location of the ELN you are attending Address Church affiliated with the ELN
City
State
Zip
IV. Additional Items Include with this application: •
A minimum one page typed essay describing your personal history, salvation experience, and what you believe concerning your Christian faith. Pay attention to grammar and spelling as this essay will also be used to assess your writing ability to succeed in college-level courses.
•
The completed LPC/ELN Online Cohort College Readiness Self-Assessment
•
A course enrollment form identifying which course/s you are planning to enroll in this term.
•
The Student Information Release Authorization if you would like to allow LPC to disclose enrollment status and grades to your ELN Leader (optional).
I hereby apply for admission to Life Pacific College and certify that to the best of my knowledge the information given in this form is true. I understand that my file may be made available to any faculty member or administrative office of LIFE PACIFIC COLLEGE.
Date
Signature Please mail this form to:
LIFE PACIFIC COLLEGE Admissions Office (Attn: ELN Liaison) 1100 Covina Blvd. San Dimas, CA 91773 877.886.5433 toll free 909.706.3070 fax [email protected] For Office Use Only
! Approved
! Denied
! Notified
LPC/ELN ONLINE COHORT College Readiness Self-Assessment Questions The following self-assessment is intended to assist you in evaluating your readiness for college-level courses. On a scale of 1-5, choose the answer that best matches your current study habits and approach to learning. Answer the questions as honestly as you can, as this will provide you with the most accurate feedback. Be sure to include this assessment with your application. Personal Goals: 1.
Can you clearly state why you are interested in taking college courses while participating in your ELN?
No 2.
2
3
4
5
Yes
5
Yes
Are you confident that you can succeed in college work?
No 3.
1
1
2
3
4
Are you planning on completing a college degree in the future?
No
1
2
3
4
5
Yes
4
5
Yes
4. Are you in control of your own success or failure?
No
1
2
3
5. When you encounter a challenging problem, do you try to solve it?
No
1
2
3
4
5
Yes
Time Management: 6.
Are you good at setting goals and deadlines for yourself and meeting them?
No 7.
1
2
3
4
5
Are you organized? Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298
!
Yes
No 8.
2
3
4
5
Yes
3
4
5
Yes
4
5
Yes
Do you keep yourself on track and on time?
No 9.
1
1
2
Do you persevere when things become difficult?
No
1
2
3
10. Are you able to spend 8-10 hours each week on an online course?
No
1
2
3
4
5
Yes
11. Do you feel that you have enough time for school and your ELN commitments?
No
1
2
3
4
5
Yes
Study Skills: 12. Are you able install software and updates, as well as upload, download, and manage files on a computer?
No
1
2
3
4
5
Yes
13. Do you regularly use the Internet to do basic research and manage email?
No
1
2
3
4
5
Yes
14. Are you able to learn new concepts and ideas, either by reading assigned materials or by conducting your own research?
No
1
2
3
4
5
Yes
15. Do you try to get the meaning of new words as you see them for the first time?
No
1
2
3
4
5
Yes
3
4
5
Yes
16. Do you look for the main ideas as you read?
No
1
2
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
17. Can you read up to 100 pages in a week per course?
No
1
2
3
4
5
Yes
18. Can you clearly summarize a college-level reading assignment?
No
1
2
3
4
5
Yes
4
5
Yes
19. Are you comfortable forming a thesis statement?
No
1
2
3
20. Can you write a paper of 5 or more organized pages that refers to two or more sources?
No
1
2
3
4
5
Yes
5
Yes
21. Are you comfortable integrating research into your essays?
No
1
2
3
4
Assessment results
This assessment is meant to be a guide for evaluating your own college preparedness. It is not a precise measurement of your likelihood of college success, but rather a starting point for discussion about your academic readiness and needs. Categories resulting in higher scores indicate a readiness to begin college coursework, while lower scores may indicate areas of individual growth. Consider reviewing your assessment results with your ELN leader in order to determine the best course of action for you. Scoring To calculate your total score, add the individual scores from each of your above answers. Total score: _________ Score 1-35: There are quite a few areas in which you may need some growth before you are ready for college-level learning. Consider reviewing your assessment with your ELN Director to explore how best to proceed.
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
Score 36-70: There are a few areas in which you may need some growth prior to beginning college-level courses. Assess your growth-areas by identifying the lower-scoring answers on this self-assessment, and consider possibilities for strengthening these areas before and during your college-learning experience. Score over 70: You are well-prepared for college-level learning. Though you seem well-equipped for college-level courses, use this self-assessment to help you identify areas which you could strengthen or further develop in order to do well academically.
Life Pacific College, 1100 Covina Blvd, San Dimas, CA 91773-3298 !
Please send this order to Life Pacific College ELN Liaison 1100 Covina Blvd San Dimas, CA 91773-3298
LPC/ELN ONLINE COHORT COURSE ENROLLMENT !Check if new address Full legal name (first middle last)
! Miss
! Mrs
Toll free 877.886.5433 Fax 909.706.3099 [email protected]
! Mr
Date Date of Birth
Address City
State
Zip
Phone Email ELN Student Signature _________________________________________________________________________________________
Online LPC/ELN Courses
Units
Cost
Year 1: Fall Courses ! Gm118 Faith for Life ! Bi113 Intro to Biblical Literature Total
3 3
$200 $200
Year 2: Fall Courses ! Ev210 Spiritual Gifts & Evangelism ! So131 Cultures of Ancient Civilizations Total
3 3
$200 $200
Year 1: Spring Courses ! Ev110 Multicultural Evangelism ! Bi101 Pentateuch Total
3 3
$200 $200
Year 2: Spring Courses ! Bi216 Synoptic Gospels ! So230 Marriage & Family Total
3 3
$200 $200
For Office Use: Course
Total
Office use: ! AP ! ED ! BN ! Paid ! Enrolled ! Phone ! Email ! Moodle ! Registrar___________
