Advantage Degree Program
Web Application


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 race 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.

School Name City: State: Zip: Graduation Year
1

 

   
2  
3  

List all the colleges from which you have taken courses.

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   

Send this link to your references for them to fill out online OR the alternative is to download and print this form and give it to your references.

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 Advantage! program?  

For which Advantage site 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.
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 Advantage! Program, home college courses, and other educational opportunities. Inquires regarding the many programs of Barclay College are always welcome, and may be directed to either the Office of Admissions or the Advantage! Coordinator.