Application
Program Application
Full Name
Address
City
Zip
State
Home Phone
Cell Phone
Social Security Number
Date of Birth
E-mail Address
Education graduation Date
(High School)
GED Date
Education graduation Date
(Collage/ Vocational School)
Degree
Phone
Current Employer
How did you hear about us
Emergency Contact
Phone
What program are you applying for
On-line MA program
Yes
No
Please Describe Any Previous Experience You Have In The
Occupation Or Schools Offers
If your are applying for a on-line class you must
submit a $275.00 Non-refundable registration fee
with the application.
Payment can be made by clicking the
(Payment Tab)
509-534-1551
509-534-1027 fax
