Online Degree Program
Web Applicaiton

This application is for the Barclay Online degree program. If you want to apply for the Haviland Campus program, please select the following link: Haviland Campus


PERSONAL INFORMATION

Name: Last   First   Middle  Maiden

Mailing Address   County   
City   State  Zip    

Phone numbers must be entered in xxx-xxx-xxxx format.
Home Phone   Work Phone  
Cell Phone   Email  

Date of Birth    (mm-dd-yyyy format)
Gender:

Social Security Number    (xxx-xx-xxxx format) 

Are you a citizen of the United States?

Are you Hispanic/Latino?

Please indicate your ethnicity by checking all that apply:


Home Church (Denomination)  


 
If Other, please enter your denomination

Emergency Contact (optional)
 
Name (first and last)  Telephone    (xxx-xxx-xxxx format) 
Address  
City  State  Zip  

EDUCATION
Please list all high schools and colleges or universities you have attended

High School Name City: State: Zip: Graduation Year
1

 

    
2  
3  

 

College Name Dates of Attendance Diploma or Degree Hours of Credit
1

2
3

You must have an official transcript sent to Barclay College directly from each institution you have attended, regardless of the amount of credit earned.

REFERENCES

Reference #1
Name    Address   
City   State  Zip   

Reference #2
Name    Address  
City   State  Zip   

Download and print a reference form for each of your references. You must complete and sign the top section of each form, and then give the forms to your references. Your references should complete the forms and return them directly to Barclay College.

Christian Faith. Tell what it means to be a Christian, give an account of where you see yourself spiritually, and explain the significance of the Christian faith for education and life. (250 words or more recommended)   

ENROLLMENT INFORMATION

How did you hear about the Barclay Online program?  

For which major are you applying?  
Anticipated start date:

I understand that completing this application does not mean acceptance. By filling in my name and the date below, I verify that all information contained in my application is correct, and that I agree to pay the $20 non-refundable applicaiton fee.
Applicant's Signature
Full Name  
Date   (mm-dd-yyyy format) 

 

Barclay College considers all applicants without regard to race, color, national or ethnic origin, age, gender, or physical disability. It does not discriminated on the basis of race, color, national or ethnic origin, age, gender, or physical disability in the administration of its enrollment policies or student-related programs.

Barclay College is a four-year Bible College founded in 1917. The college is accredited by the Association for Biblical Higher Education, and offers both traditional and continuing education at the main campus in Haviland, Kansas, adult degree completion options through the Online and Advantage! Programs, home college courses, and other educational opportunities. Inquires regarding the many programs of Barclay College are always welcome, and may be directed to the Office of Admissions.