wesley
WESLEY SEMINARY | HEARTLAND CHURCH
WESLEY
UNCLASSIFIED APPLICATION/REGISTRATION
SEMINARY IND ANA WESLEYAN UNIVERSITY
Students not desiring a degree may be accepted as an “unclassified” status by completing the application below. Unclassified students may earn a maximum of 18 hours under this status. After completing 18 hours, students must go through the normal admission process. Students who are unclassified are not eligible for financial aid. Students desiring to take a graduate course must also provide a transcript showing an undergraduate degree. Please complete all sections of the application and registration form. This form must be received a minimum of three weeks prior to the start date of the elective class.
SECTION ONE – PERSONAL INFORMATION Name
First
Middle
Last
Address
City/ State/ Province
Book shipping address (if different than above)
Street (no PO boxes)
Daytime phone
Work phone
Email address
Birth Date
Country of citinzenship
(Nickname) Zip/ Postcal code City
Country State
Zip
SSN
Primary language if not English
If you are not a US citizen, please make a copy of your VISA or permanent residency status to: Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380. Gender:
□ Male □ Female
Ethnicity:
Race: (check all that apply)
□ Hispanic □ Non-hispanic
Religious denomination:
□ American Ind/ Alaskan Native □ Black or African American □ White □ Asian □ Native Hawaiian/ Other □ Pacific Islander
Marital status:
□ Single □ Married □ Separated □ Widowed □ Divorced
SECTION TWO – EDUCATIONAL BACKGROUND Please indicate whether you are a High School Graduate or have obtained your GED.
□ High School Graduate □ GED
Name of High School: _______________________________
Have you taken classes through IWU before?
□ Yes
□ No
If yes, please indicate the dates you attended: ________________________________________ PAGE 1
08.16.17
WESLEY SEMINARY | HEARTLAND CHURCH
UNCLASSIFIED APPLICATION/REGISTRATION SECTION THREE – ACADEMIC INFORMATION The course I am registering for is: MIN597,OPXJOH+FTVT"/FX5FTUBNFOU4UVEZ Proof of a baccalaureate degree is required for students taking a graduate course. Send transcripts to: Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380
SECTION FOUR – FINANCIAL INFORMATION The cost of the course I am registering for is: $180.00 METHOD OF PAYMENT Check one for both tuition and books/tech fee: You will not be registered until payment is received.
□ Visa/ Mastercard/ Discover
Card number: ________________________________________________________ Expiration date: ________________ V code (3 digits on back of card): _____________
□ Check/ Money order
Enclosed : $____________________
Any changes to this registration (withdraw or addition) must be made through the Registration Change Counselors. Your signature below indicates academic and financial responsibility for all courses listed above.
Signature
Date
Email forms to [email protected]
FOR OFFICE USE ONLY: ID #: __________________________ Amount recieved: _______________ Check #: ________________ Tuition: ___________ Book/ Tech fees: ___________ Late fee: ___________ AC approval: ___________ Date registered by student services: ___________
PAGE 2
08.16.17
WESLEY
UNCLASSIFIED APPLICATION/REGISTRATION
SEMINARY IND ANA WESLEYAN UNIVERSITY
Students not desiring a degree may be accepted as an “unclassified” status by completing the application below. Unclassified students may earn a maximum of 18 hours under this status. After completing 18 hours, students must go through the normal admission process. Students who are unclassified are not eligible for financial aid. Students desiring to take a graduate course must also provide a transcript showing an undergraduate degree. Please complete all sections of the application and registration form. This form must be received a minimum of three weeks prior to the start date of the elective class.
SECTION ONE – PERSONAL INFORMATION Name
First
Middle
Last
Address
City/ State/ Province
Book shipping address (if different than above)
Street (no PO boxes)
Daytime phone
Work phone
Email address
Birth Date
Country of citinzenship
(Nickname) Zip/ Postcal code City
Country State
Zip
SSN
Primary language if not English
If you are not a US citizen, please make a copy of your VISA or permanent residency status to: Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380. Gender:
□ Male □ Female
Ethnicity:
Race: (check all that apply)
□ Hispanic □ Non-hispanic
Religious denomination:
□ American Ind/ Alaskan Native □ Black or African American □ White □ Asian □ Native Hawaiian/ Other □ Pacific Islander
Marital status:
□ Single □ Married □ Separated □ Widowed □ Divorced
SECTION TWO – EDUCATIONAL BACKGROUND Please indicate whether you are a High School Graduate or have obtained your GED.
□ High School Graduate □ GED
Name of High School: _______________________________
Have you taken classes through IWU before?
□ Yes
□ No
If yes, please indicate the dates you attended: ________________________________________ PAGE 1
08.16.17
WESLEY SEMINARY | HEARTLAND CHURCH
UNCLASSIFIED APPLICATION/REGISTRATION SECTION THREE – ACADEMIC INFORMATION The course I am registering for is: MIN597,OPXJOH+FTVT"/FX5FTUBNFOU4UVEZ Proof of a baccalaureate degree is required for students taking a graduate course. Send transcripts to: Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380
SECTION FOUR – FINANCIAL INFORMATION The cost of the course I am registering for is: $180.00 METHOD OF PAYMENT Check one for both tuition and books/tech fee: You will not be registered until payment is received.
□ Visa/ Mastercard/ Discover
Card number: ________________________________________________________ Expiration date: ________________ V code (3 digits on back of card): _____________
□ Check/ Money order
Enclosed : $____________________
Any changes to this registration (withdraw or addition) must be made through the Registration Change Counselors. Your signature below indicates academic and financial responsibility for all courses listed above.
Signature
Date
Email forms to [email protected]
FOR OFFICE USE ONLY: ID #: __________________________ Amount recieved: _______________ Check #: ________________ Tuition: ___________ Book/ Tech fees: ___________ Late fee: ___________ AC approval: ___________ Date registered by student services: ___________
PAGE 2
08.16.17
