AGE Application, Bluffton University

ApplicationBiographicalEmploymentEducationFinancial AidMilitary ServiceOptionalCompletion

Program:
For enrollment beginning:
Location:

How did you first learn of this Bluffton program?

Instructions:

Complete this application in full.
Request that an official transcript be sent from each college/university you attended.
Request completion of recommendation form(s) by the appropriate individuals. (Waived for social work students)
Graduate program applicants only – Complete three essay questions. Email to: adulted@bluffton.edu.
Graduate Business program applicants only – Email a copy of your current resume. Email to: adulted@bluffton.edu.

First:

Middle:

Maiden:

Last:

Other name(s) under which your transcript may be located:

Gender:

Male Female

Address:
City:				State:				Zip:

Daytime phone:
Evening phone:
E-mail address:

Date of birth:
Social security number:
U.S. citizen:		Yes No

Have you been convicted of a felony?

Yes No

If so, please explain:

Current employment

Are you employed?

Full time Part time No

Employer:
Telephone:	May we contact you at this number?			Yes No
Address:
City:		State:	Zip:

How may years have you been with this employer?

Position held:

Previous employment

Employer:
Telephone:
Address:
City:	State:	Zip:

Colleges / Universities Attended

Institution	Dates Attended	Degree(s) Received	# of Hours Taken	Type of Hours

Have you ever been placed on academic probation or suspended from any college?

Yes No

Date(s) of suspension or probation:

Were you eligible to return?

Yes No

Reason for suspension:

If you wish to apply for financial aid, you must submit the Free Application for Federal Student Aid (FAFSA) available through the Office of Adult and Graduate Studies or visit www.fafsa.gov

Will you apply for financial aid:

Yes No

If you have applied, approximate date:

Do you need forms?

Yes No

Are you applying for veteran’s benefits?

Yes No

Do you expect to receive employer or third party reimbursement?

Yes No

(If yes, please submit policy)

Have you served in the armed forces?

Yes No

If yes, what branch?
How long?

(BCOMP and HRM only)

Do you have educational training from the military that you would like to have evaluated for possible college credit?
Yes * No
* If so, verification of training must be submitted.

Bluffton University admits students of any race, color, and national or ethnic origin, regardless of gender or disability. Information provided here will be used to conduct institutional research related to governmental recordkeeping and statistical reporting requirements. It will in no way affect your application for admission.

Are you Hispanic or Latino?

Yes No

Please indicate your race by checking one or more of the boxes below:

		American Indian or Alaska Native
		Asian
		Black or African American
		Native Hawaiian or Other Pacific Islander
		White

Church affiliation:

Upon admittance to Bluffton University, I agree to comply with the rules and regulations and shall respect Bluffton’s standards while enrolled as a student. I recognize that these standards involve good citizenship, personal honor, regard for the rights of others and respect for duly constituted leadership.

To submit your application for admission to Bluffton University click the APPLY button.