Center for Lifelong Learning

Application for Admission

This is a formal application for undergraduate admission to the college. In order to be processed you must request that official transcripts of all prior course work be sent to the Center for Lifelong Learning.

Thank you!

First Name:
Last Name:
Former/Maiden Name: 
Address: 
City: 
State: 
County: 
Zip Code: 
Date of Birth: 
Social Security Number: 
Gender:  Male  Female 
Telephone (day): 
Telephone (evening): 
Telephone (cell): 
Email address: 
Occupation: 
Business Name: 
High School: 
High School Graduation Year: 
Please list, in chronological order, ALL colleges and universities you have attended, including Cedar Crest College
College/University
Dates Attended
DegreeAwarded
   
College/University
Dates Attended
DegreeAwarded
   
College/University
Dates Attended
DegreeAwarded
Marital Status:  Single  Married  Divorced 
Are you a US Citizen?  Yes  No
If no, of what country are you a citizen? 
Resident Alien Number:
Visa Status:
Do you plan to apply for financial aid? Yes  No
Do you receive Tuition Reimbursement? Yes  No
Term you wish to enter: 
Do you wish to enter:  Part-time Full-time
Have you previously applied to or attended Cedar Crest?:  Yes No
Please briefly state your interest in attending Cedar Crest College:
Diversity data (optional):

This information is not used to determine admissibility		 African American/Black
Native American/American Indian
Asian American/Pacific Islander
Caucasian/White
Hispanic/Latino Chicano
Other
No Response
Academic Interest  
(First Choice): 
Academic Interest
(Second Choice): 
Nursing Students: Day Clinicals
Evening Clinicals
Student Status Requested: Matriculated Degree Candidate
Non matriculated Student
Certificate or Certification Candidate
Visiting Student

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