| Personal Information |
| First Name: |
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| Middle Initial: |
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| Last Name: |
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| Maiden Name: |
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| Program: |
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| Social Security Number: |
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| Mailing Address: |
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| City: |
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| State: |
Zip:
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| Home Phone: |
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| Work Phone: |
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| Cell Phone: |
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| E-Mail: |
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| D.O.B. (MM/DD/YR): |
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| Are you a United States Citizen? |
Yes
No
*If you are not a U.S. citizen, send our office a copy of your visa or permanent residency status. |
| Nation of citizenship: |
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| Visa Type, Number: |
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| How did you hear about ENC? |
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| Desired program start date (month): |
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| Preferred Location: |
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| Academic Information |
| Name of High School: |
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| Graduation Date: |
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Diploma
GED |
Please list all colleges attended, including Eastern Nazarene College:
Please request official transcripts from all colleges attended to be sent to Eastern Nazarene College, Adult and Graduate Studies Division. |
| College / University Name: |
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| Dates Attended: |
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| Estimated Credits: |
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| College / University Name: |
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| Dates Attended: |
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| Estimated Credits: |
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| College / University Name: |
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| Dates Attended: |
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| Estimated Credits: |
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| College / University Name: |
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| Dates Attended: |
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| Estimated Credits: |
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| Did you receive a degree? |
Yes
No |
| If yes, degree received: |
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| Do you have miliatry experience? |
Yes
No |
| If yes, for evaluation of academic credit, please submit a copy of DD214 or DD295. |
| Do you speak, read, and write English as your primary language? |
Yes
No |
| If no, a passing score in either the TOEFL exam or an ENC placement test must be submitted prior to evaluation. |
| Employment History |
| Current Employer: |
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| Address: |
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| Position: |
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Full Time
Part Time |
| Length of Employment: |
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| Previous Employer: |
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| Address: |
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| Position: |
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Full Time
Part Time |
| Length of Employment: |
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| Previous Employer: |
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| Address: |
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| Position: |
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Full Time
Part Time |
| Length of Employment: |
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| Will your employer provide tuition reimbursement? |
Yes
No |
| If yes, percent: |
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| Federal and State agencies request that we supply demographic data on applicants for admission to Eastern Nazarene College. Please complete this section. If you choose not to answer any part of this section, it will in no way affect your admission to Eastern Nazarene College. |
| Birthplace: |
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| Gender: |
Male
Female |
| Marital Status: |
Single
Married
Divorced
Widowed |
| Ethnicity: |
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| Religious Affiliation: |
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| Do you have Health Insurance? |
Yes
No |
| If yes, name of carrier: |
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| Policy Number: |
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| If no, you will be required to participate in the college program. |
| Deposit |
In addition to this application, submit a non-refundable deposit of $50 for AA/BA/BS programs, or $75 for MS program (check or money order), made payable to Eastern Nazarene College, Adult and Graduate Studies Division. This fee covers our evaluation of your transcripts and documents and is paid by all applicants.
Your continuation in the program after the end of the second module will be contingent on our receipt
of all official transcripts and your meeting minimum grade point requirements.
Send deposit and additional documents to: Eastern Nazarene College, Adult and Graduate Studies Division, ATTN: Karyn Donahue, 180 Old Colony Avenue, Quincy, MA 02170 or Fax to 617-984-4901. |
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Eastern Nazarene College admits students of any race, color, gender, creed, ethnic or national origin, handicap, or age to all the rights, privileges, programs, or activities generally accorded or made available to students at the college. It does not discriminate on the basis of race, color, ethnic or national origin in administration of its educational policies, admissions policies, scholarship and loan programs, athletic, and other school-administered programs. Eastern Nazarene College reserves the right to deny admission or re-admission to any applicant it views as inappropriate for its programs based on academic, financial, or behavioral considerations. |
Studies
