College of Adult and Professional Studies
1900 W 50th St
Marion IN 46953
Unclassified Application/Registration
Students not desiring a degree may be accepted as an "unclassified" status by completing the application below.
Unclassified students may earn a maximum of 18 hours under this status. After completing 18 hours, students
must go through the normal admission process. Students who are unclassified are not eligible for financial aid.
Students desiring to take a graduate course must also provide a transcript showing an undergraduate degree.
Please complete all sections of the application and registration form. This form must be received a minimum of
three weeks prior to the start date of the elective class.
SECTION ONE – PERSONAL INFORMATION
Name
First
Middle
Last
(Nickname)
Address
City State/Province
Zip/Postal Code
Country
Book Shipping Address (If different than above)
Street (No PO Boxes)
Daytime Phone
City State
Zip
Work Phone
E-mail Address
Birth Date
Country of citizenship
Primary Language if not English
SSN
If you are not a US citizen, please make a copy of your VISA or permanent residency status to:
Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380
Gender:
Ethnic:
Male
Female
Religious Denomination:
Hispanic
Non-Hispanic
Race: (check all that apply)
American Ind/Alaskan Native
Black or African American
White
Asian
Native Hawaiian/Other
Pacific Islander
Marital Status:
Single
Married
Separated
Widowed
Divorced
SECTION TWO – EDUCATIONAL BACKGROUND
Please indicate whether you are a High School Graduate or have obtained your GED.
□
High School Graduate
□
GED
Name of High School: _________________________
Have you taken classes through IWU or Marion College before? □ Yes
□ No
If “Yes” please indicate the dates you attended IWU or Marion College: _________________________
SECTION THREE – ACADEMIC INFORMATION
The course I am registering for is an/a: □ Undergraduate Elective □ Graduate Elective
Proof of a baccalaureate degree is required for students taking a graduate elective course.
Send transcripts to:
Indiana Wesleyan University, Student Services, 1900 W. 50th Street, Marion, IN 46953 or fax to 765-677-2380
Submission of this registration form will initiate your registration into these courses:
CODE (ex. BIL101 A)
Class Name
City or Online
Start Date
End Date
Deadline
Tuition$
Books$
(The Life Application Study Bible is required for BIL 101, 102, 120, and 201. If you do not already possess this Bible, you
must purchase it from IWU Textbook Distribution. Please call 1-800-621-8667 opt #6 or 765-677-2854 to order.)
SECTION FOUR – FINANCIAL INFORMATION
If you are applying to Indiana Wesleyan University for the first time, a one-time non-refundable application fee of $25 MUST
accompany this application.
METHOD OF PAYMENT (check one for both application fee and tuition and books): (You will not be registered until
payment is received)
□ Visa/MasterCard/Discover Card Number:
Expiration Date:
V Code (3 digits on back of card):
Charge for application
Charge books/materials
Charge Tuition
□ Check/Money Order Enclosed: $
□ Employer Voucher (an actual voucher must be received by the registration deadline date, NOT a voucher application)
□ Tuition Deferral – Contract on file.
Any changes to this registration (withdraw or addition) must be made through the Registration Change Counselors.
Your signature below indicates academic and financial responsibility for all courses listed above.
Signature
Date
Mail or fax registration form to: Indiana Wesleyan University, 1900 W. 50th Street, Marion, Indiana 46953-5279
FAX: 765-677-2760. (If faxing, call 800-621-8667 ext. 2878 to verify.)
If you have questions concerning registration, call: 765-677-2343 or 800-621-8667 ext. 2343
FOR OFFICE USE ONLY:
ID#
Application:
Accounting Office:
Amount Received:
Tuition:
AGS
IPD
Date Registered by Student Services:
Check #
Books:
Late Fee:
AC Approval: