Application for Continuing Education Courses


Application for Spiritual Guidance Mentoring Certificate and Noncredit/Continuing Education Courses

Salutation:

* First Name:

* Last Name:

Maiden Name:

Title:

* Address:

Address 2:

* City:

* State:

* Zip:

* Country:

* Phone:

* Email:

*Re-enter Email:

Gender:

Male

Female

Date of Birth:

Program for which you are applying:

			Lifelong Learning, Noncredit Courses
			Spiritual Guidance Mentor Training (SGMT) Certificate

Education:

High School Diploma/GED

Name and Location of High School

Certificates and Training

List in chronological order all colleges or universities you have attended.

Occupation:

Professional Affiliations:

How did you hear about Atlantic University?:

Submit your admissions essay to admissions@atlanticuniv.edu. Refer to the noncredit program page for essay guidelines.

*I have read the A.U. Tuition Protection Agreement and agree. view...

*The information given is true and correct to the best of my knowledge.

A $35 non-refundable fee is required to process your application.

Billing Information:

*Name on Credit Card:

* Credit Card Type:

* Card Number:

* Expiration Date:

By submitting this form, you are agreeing to our collection, storage, use, and disclosure of your personal info in accordance with our privacy policy.

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By submitting this form, you are certifying that the information
given in this application is correct to the best of your knowledge.