College Application Eucon International College and School of Saipan

EUCON INTERNATIONAL COLLEGE : ONLINE APPLICATION FORM

APPLICANT PERSONAL INFORMATION
*Today's Date*
*Desired Date to Enter Eucon*
*Your Legal Name*
*Present Address*
*Your Telephone*
*E-mail*
*Citizenship*
*Ethnic Group*
*Your Gender*
*Birthdate*
*Present Age*
*Height (feet/inches)*
Weight (in pounds)
*Soc. Sec. Number*
*Marital Status*
*No. of Dependent Children*	WHO DO YOU LIVE WITH?
*Male Guardian*
*Female Guardian*
*GuardianAddress*
*Home Phone*
*Cellphone*
*Pager*
*Father's Employer and Work Phone*
*Mother's Employer and Work Phone*
*Status of Natural Father*
*Status of Natural Mother*
*Legal Guardian*	SCHOOLS YOU HAVE ATTENDED (Give name, address, attendance dates, graduation date)
*Elementary*
*Middle School*
*High School*
*College*
*Other*
*Ever Held Back?*
*Have you taken TOEFL Test?*
*Have you taken ACT or SAT?*
*Your Reason for Selecting Eucon*	Maximum 250 Words Acceptance of your application is contingent upon receiving copies of your recent school tran-scripts, health certificate, criminal clearance, passport, and a current 2" photo. Please mail or bring these promptly to the Eucon office. YOUR HEALTH HISTORY Please check below whether you have experienced any of the following conditions:
	*Glasses*
	*Contact Lenses*
	*Visual Impairment*
	*Hearing Problem*
	*Partial Deafness*
	*Hearing Aid*
	*Speech Problem*
	*Asthma*
	*Diabetes*
*Describe any allergies that you may have*	Describe here any allergies you may have (or write "None")
*List any medications you take and why*	List here any medications you may take and why you take them (or wrote "None")
Describe here any health conditions not listed above	Describe here any health conditions not listed above (or write "None")
*Your Physician*	Check here if you . . .
	*Have ever used or currently use illegal or dangerous drugs*
	*Use alcoholic beverages in any way*
	*Use tobacco in any form*
	*Have ever been expelled, dropped, or suspended by any school or college*
	*Have ever been or are currently under supervision of a parole officer or court*
	*Have ever been arrested for any reason other than a minor traffic violation*
*If you answered yes to any of the above questions, give complete details here*	Maximum 500 words REQUIRED REFERENCES Eucon requires each applicant to submit three references from teachers, principles, employers, pastors, adult family friends or other non-relatives who know you well. Please provide their names and phone numbers or e-mail addresses so that the Admissions Office may contact them.
*Reference 1*
*Reference 2*
*Reference 3*	CERTIFICATION Read the agreement below and then indicate your acceptance of these terms In making the above application it is my desire to receive a quality education in a highly moral atmosphere. I absolve Eucon International College of any injury to me on campus or during any College activity. I understand that my atten-dance is a privilege and not a right, and that if at any time my conduct or cooperation with the college's authorities is not in keeping with the College's requirements then the College reserves the right to terminate my enrollment. *If I voluntarily withdraw from the College or if I am requested by the College to withdraw, then I understand that my registration fee will not be refunded.* I am willing to abide by the College Student Handbook including all the rules and regulations, dress and hair standards, and discipline policies. I will cooperate with all the standards outlined therein. I will be diligent in all classwork and homework. I will cooperate with the College and do my part to make this a rewarding and unforgettable year. With the indication of my agreement to these conditions I certify that the information given in this application is true.
*Do you agree?*
*Reconfirm your e-mail address*	Nondiscriminatory Policy : Students of any race, color, national and ethnic origin are admitted to all the rights, privileges, and activities generally accorded or made available to students at Eucon International College and School. Eucon does not discriminate on the basis of race, color, national or ethnic origin in its administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.