Online Application – Central Christian University

Full Name*

First Last

Gender*

Social Security

Birthdate*

Age*

Please enter a value between 10 and 120.

Birthplace*

Nationality*

Language*

Address Information*

Physical Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Adress*

Same as previous

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Mobile phone*

Email*

Interest Program*

Area of Study*

Educational Background*

High School / GED	Graduation Date	GPA	Diploma obtained

In order to process your application for review/enrollment, a non-refundable application fee of $150 USD is required and an Admissions Counselor will contact you after reviewing your submission.*

Fee: $150.00

*If admitted $150.00 USD application fee will go towards annual registration fee.

Credit Card Information*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Terms and Conditions*

I have read Chaplains of Florida catalog or viewed website and agree to abide by the standards as set forth and I have told the truth to the best of my ability on this application. I further acknowledge that no other representations have been made to me in writing or orally other than what is stated in the Central Christian University catalog. I further give Central Christian University permission to order and review transcripts form educational institutions I have previously attended and at the discretion of the University, may request a Pastor’s recommendation to assist in the admissions counselors in their decision. I further permit Central Christian University and its representatives to use photographs or videotapes that may include me for instructional or promotional purposes. I understand that my application fee is non-refundable. All information given in this application is subject to verification and will be confidential.

Nombre

This field is for validation purposes and should be left unchanged.