| LIFE EXPERIENCE APPLICATION FORM |
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Please PRINT or TYPE. Please answer all questions. Incomplete applications will be returned and may delay your acceptance to PCU. If the question does not pertain to you please enter N/A. Date and sign your completed application and submit with listed (non-refundable) $25 fee payment to: PCU, Admissions, P. O. Box 5304, Kaneohe, HI 96744.
Please see student handbook for more information on Life Experience Credits.
Personal Information
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Last Name |
First Name |
M.I. |
SR, JR or |
Maiden Name, if applicable |
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Social Security Number |
Signature My signature certifies that the following information and statements are true and accurate and can be verified to the best of my knowledge. |
Date |
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Experience
#1: ___________________________________________________________________
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Church/Ministry Name |
Church Address, City, State, Zip |
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Phone |
Verifying Staff Member & Title. |
Your Title/Position |
Start date |
End date
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Please explain your duties and responsibilities (attach sheet if more space is needed) |
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Explain your goals and accomplishments. (attach sheet if more space is needed) |
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Experience
#2:
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Church/Ministry Name |
Church Address, City, State, Zip |
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Phone |
Verifying Staff Member & Title. |
Your Title/Position |
Start date |
End date
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Please explain your duties and responsibilities (attach sheet if more space is needed) |
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Explain your goals and accomplishments. (attach sheet if more space is needed) |
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Please make additional copies of this page as needed.
Non-Discrimination Policy
Pacific Christian University affirms that all men are created in the image of God and are, therefore, to be afforded equal opportunity in accordance with biblical standards. These policies are administered to without regard to gender, color, national or ethnic origin, recognizing that all mankind is one human race.
Please see Student Handbook for Privacy Rights
Life Application Form, Rev 001 Date: Fri, 21 Sep 2007 (c) 2007 Pacific Christian University