Student Application

PEACE MULTICULTURAL UNIVERSITY

STUDENT APPLICATION

Student Personal Information

Academic Program

First Name

Last Name

Email

Telephone Number

Address

City

States

Zip

Race

Caucasian Hispanic African American Native American Asian/Pacific Other

Please specify

Date of Birth

Gender

Male Female

Hobbies

Talents

References:

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Educational Summary:

High School:

High School Name

High School City

States

Year Of Graduation

Grade Point Average

Colleges:

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Certification

I hereby certify that all information that I have completed and submitted as a part of this application process is true, correct, and accurately reflects my background.

Yes No

First Name

Last Name

REFERENCE #random_string:

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Reference Name

Reference Address

Reference City

Reference State

Reference Zip Code

Reference Phone Number

College Experience:

remove NOTE: List the most recent college/university experience first.

COLLEGE #random_string:

College/University Name

College/University City

College/University State

Major

Year of Graduation

Approximate Grade Point Average (GPA)