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EIC ONLINE APPLICATION FORM: | |
| Today's
Date
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| Desired Date to Enter
Eucon
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| Your Legal
Name
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| Present
Address
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| Your Telephone
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| E-mail
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| Citizenship
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| Ethnic
Group
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| Your Gender
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| Birthdate
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| Present
Age
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| Height
(feet/inches) |
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| Weight
(in pounds) |
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| Soc. Sec.
Number
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| Marital
Status
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| No. of Dependent
Children
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WHO DO YOU LIVE WITH? |
| Male
Guardian
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| Female
Guardian
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| GuardianAddress
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| Home
Phone
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| Cellphone
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| Pager
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| Father's
Employer and Work Phone
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| Mother's
Employer and Work Phone
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| Status of Natural
Father
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| Status of Natural
Mother
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| Legal
Guardian
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SCHOOLS YOU HAVE ATTENDED (Give name, address, attendance dates, graduation date) |
| Elementary
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| Middle
School
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| High
School
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| College
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| Other
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| Ever Held
Back?
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| Have you taken TOEFL
Test?
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| Have you taken ACT or
SAT?
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| Your Reason for Selecting
Eucon
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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. International students may click here to download a checklist of required documents YOUR HEALTH HISTORY Please check below whether you have experienced any of the following conditions: |
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Glasses |
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Contact Lenses |
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Visual Impairment |
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Hearing Problem |
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Partial Deafness |
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Hearing Aid |
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Speech Problem |
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Asthma |
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Diabetes
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| Describe any allergies that you may
have
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List any medications you take and
why
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Describe here any health conditions
not listed above
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Your
Physician
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Check here if you . . . |
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Have ever used or currently use illegal or dangerous drugs |
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Use alcoholic beverages in any way |
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Use tobacco in any form |
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Have ever been expelled, dropped, or suspended by any school or college |
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Have ever been or are currently under supervision of a parole officer or court |
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Have ever been arrested for any reason other than a minor traffic violation
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If yes, give complete details
here
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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
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| Reference
2
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| Reference
3
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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. Download Eucon International College Student Handbook
Download Statement of Cooperation
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Do you
agree?
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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. |
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| Student Life:: |
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