Huntington University: Application for Enrollment in EXCEL Program

Application for Enrollment in EXCEL Program
Please complete the form below. Mail $20 application fee to:
Huntington University EXCEL Program, 2303 College Avenue, Huntington, IN 46750

FIRST-TIME APPLICANTS PAY A $20 APPLICATION FEE.

Name

Address

Biography

Birthplace Birth Date

Male Female Marital Status:

Country of Citizenship: U.S. Other:

Religious Affiliation Ethnicity (optional)

Did either of your parents attend school after high school? Yes No

Intended Date of Enrollment in EXCEL:

Education

Graduation Date

Have you attended Huntington University before? Yes No

List all colleges/universities you have previously attended:

Institution	City, State	Dates Attended	Degree Earned

Employer

Dates Employed

Referral

How did you first become aware of the EXCEL Program?
Please include the name(s) of people who may have influenced you.

By clicking the Submit button below, I certify that the above information is
accurate and complete; and if my application is approved, I agree to abide
by the policies, rules, and regulations of Huntington University. I understand
my application is not complete until Huntington University receives my
application fee of $20 (US).

Mail $20 application fee to:
Huntington University EXCEL Program, 2303 College Avenue, Huntington, IN 46750
(Click here for an Application Fee Voucher Form to accompany your check.)

To learn more, please call (260) 359-4162 or (800) 600-4888
or email excel@huntington.edu



	Contact Us \| 2303 College Avenue Huntington Indiana 46750 \| 260.356.6000 \| Copyright 2004