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APPLICATION FOR ADMISSION

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APPLICANT INFORMATION

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EDUCATION

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EMPLOYMENT HISTORY

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REGISTRATION

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PERSONAL

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TERMS

APPLICANT INFORMATION

EDUCATION

EMPLOYMENT HISTORY

REGISTRATION

Semester

Status

Survey

Survey

Please indicate how you became interested in Elyon College:

PERSONAL

In the event of emergency, please provide the following information:

STATEMENT OF TERMS

In consideration of the undertaking by the Admission Office to process this form, I agree that the information furnished is accurate to the best of my knowledge. Elyon College agrees to treat all information contained herein and any additional information received from other sources in a confidential manner.

I authorize Elyon College to use my name and/or photograph for advertising or other promotional purposes. I agree to comply with the terms and conditions set forth in the College catalog.

Non-Discrimination

Elyon College shall adhere to all applicable non-discrimination laws and regulations. The College shall admit students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to its students and shall not discriminate on the basis of race in administration of its educational policies, admission policies, scholarship and loan programs and athletic or other school administered programs

HIGH SCHOOL TRANSCRIPT RELEASE

I hereby certify that I am / am not a High School graduate.

(Circle whichever applies)

My signature below gives ____________________________________ my permission
(School’s Name) to release a transcript of my grades to Elyon College, 1400 West 6 Street, Brooklyn, NY 11204.

I last attended / graduated from your High School in ________________ (Circle whichever applies) Date

APPLICANT SIGNATURE _____________________________ DATE___________________________