Application for Enrollment as a Special Student - Adults 62

* Birthdate:

Gender (optional):    Male     Female

Country of citizenship (optional):    

Are you a U.S. resident (optional)? Yes    No

Ethnic origin (optional):
Are you Hispanic or Latino?

What is your race? Select one or more.
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander

Church (denominational) affiliation:    

* Class Applying for: (Some courses are by department permission only) 

Course #:     Title:   Credit     Audit

Course #:     Title:  Credit     Audit

 Admission Statement

George Fox University seeks to admit students who will best succeed and benefit from a distinctly Christian education and environment. Members of the George Fox community demonstrate Christian values and are committed to the integration of faith and learning. All students are expected to respect the spirit & intention of the George Fox community while on campus or at off-campus class locations (see Catalog or Program Guide for more information).

* Please check the following statements: 

I agree to the terms and conditions associated with my enrollment. I understand that this confirms my intention to attend classes in the term
listed above. If I should choose to cancel my enrollment or withdraw from the institution I understand that it is my responsi bility to contact the
Registrar's Office to withdraw from the institution.

 I understand that I am responsible for all costs associated with my enrollment and that failure to make payment by each due date will result
in a 1% late payment fee calculated on the past due balance (12% APR) in addition to enrollment and transcript holds. I a lso understand that my
account may be reported to a national credit bureau and if my account must be submitted to a collection agency, I am responsible for all costs incurred including attorney and collection fees.

Your submission of this form is your affirmation that you have read and understand the above statement and are willing to cooperate with the purposes and expectations for George Fox University.

Thank you.