Program Type:

Program Of  Interest:

Street Address1

District

City

State

Post Code

Country

Home Phone(XXX)123-4567

Work Phone(XXX)123-4567

Fax Number(XXX)123-4567

Mobile Number(XXX)123-4567

List all Colleges and Universities attend

Qualification Award & Grade

From: (MM/YYYY)  

To:(MM/YYYY)

Organization Name

Position & Job Speification

Year of Services

Professional Qualification

Name of Educational, Training or Professional Institutions

Year

Preferred Payment Method: Select Bank Draft Cashier Check Personal Check

NON-DISCRIMINATORY DECLARATION

Southern Pacific University admits students of any race, color, national or ethnic origin to all rights, privileges, programs and activities generally accorded or made available to students. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies and any other school administered programs or employment.

I understand that any misrepresentation or omission of facts in my application will justify denial or cancellation of admission to the University before or after enrollment.

SOUTHERN PACIFIC UNIVERSITY IS NOT ACCREDITED BY AN ACCREDITING AGENCY RECOGNIZED BY THE UNITED STATES SECRETARY OF EDUCATION.

Note: In the United States, many licensing authorities require accredited degrees as the basis for eligibility for licensing. In some cases, accredited colleges may not accept for transfer courses and degrees completed at unaccredited colleges, and some employers may require an accredited degree as a basis for eligibility for employment.