Multnomah University Guest ApplicationPage 1Guest Application for AdmissionYou should complete this application if you wish to attend Multnomah as a part-time, non-degree-seeking student. Guest students may take no more than 6 credits per semester and no more than 12 credits in total over the course of three consecutive semesters. Guest students are not eligible for financial aid. CampusPortland CampusOnline Admission forPlease select...August 2019 (Fall Semester, A Session) Admission forPlease select...Fall Semester 2019 (August) Name First Name Middle Name Last Name Preferred First Name (If Different) E-mail Cell Phone Home Phone Allow Text MessagesAllowDo Not Allow Mailing Address CityPlease select...AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWYOutside the USAAAEAPASDCFMGUPWVI State Zip CodeAdditional Personal Information Are you a U.S. Citizen?YesNo Are you a U.S. Permanent Resident?YesNoAn international student is one who will be attending a university in the United States without residency or citizenship, typically on an F-1 visa. International students have additional application requirements as part of the Visa application process, often including an English language proficiency exam and transcript evaluation by an evaluation service. The admissions department can assist with questions about this process. Country of CitizenshipPlease select...United States of AmericaCanadaAfghanistanAlbaniaAlgeriaAndorraAngolaAntiguaArgentinaArubaAustriaAustraliaAzoresBahamasBahrainBalearic IslandsBangladeshBarbadosBelgiumBelizeBeninBermudaBhutanBoliviaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanal ZoneCanary IslandsCape Verde IslandsCayman IslandsCentral African RepublicChadChilePeoples' Republic of ChinaColombiaComoro IslandsCongoCook IslandsCorsicaCosta RicaCote d'IvoireCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEnglandEquatorial GuineaEstoniaEthiopiaEast TimorFaroe IslandsFiji IslandsFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuinea-BissauGuineaGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitLaosLatviaLebanonLeeward IslandsLesothoLiberiaLibyaLiechtensteinLithuaniaLaosLuxembourgMacaoRepublic of MacedoniaMadeira IslandsMalagasyMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMexicoFederated States MicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherland AntillesNetherlandsNevisNew BritainNew CaledoniaNew HebridesNew ZealandNicaraguaNigerNigeriaNorth KoreaNorthern IrelandNorwayOkinawaPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPrincipeQatarReunion IslandsRomaniaRussiaRwandaRyukyu IslandsSaudi ArabiaSouth AfricaScotlandSenegalSeychelles IslandsSierra LeoneSikkimSingaporeSouth KoreaSlovakiaSloveniaSolomon IslandsSomoliaSpainSpanish North AfricaSpanish SaharaSri LankaSanta Cruz IslandsSt. KittsSt. LuciaSt. ThomasSt. VincentSudanSultanate of OmanSurinameSouthwest AfricaSwazilandSwedenSwitzerlandSouth YemenSyriaTaiwanTanzaniaThailandTobagoTogoTongaTrinidadTurks IslandTunisiaTurkeyTuvaluUgandaUnited KingdomUkraineUnited Arab EmiratesUruguayVatican CityVenezuelaVietnamVirgin IslandsWalesWindward IslandsWestern SamoaYemenYugoslaviaZaireZambiaZimbabwe Date of Birth GenderFemaleMaleEthnic & Racial Information (Optional) Are you Hispanic/Latino?YesNoOptional - this information will not be a factor in your admission decision Please select one or more of the following races:American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite or CaucasianOptional - this information will not be a factor in your admission decisionHidden Fields Student (Record Type) Constituent (Record Type) Household (Record Type) Educational Institution (Record Type)Page 2Academic History Academic Background Highest level of study completedPlease select...High School or GED CompletedSome College CompletedBachelor's Degree CompletedSome Graduate Study CompleteMaster's Degree CompletedOther Please explain:Lifestyle & Background Have you used illegal substances within the last year?YesNo If yes, please provide an explanation Have you pled guilty (or no contest), been adjudicated, or otherwise been convicted of a crime or subject to a civil indictment or other disciplinary action?YesNo Do not include infractions such as speeding tickets. Have you committed your life to Jesus Christ as your personal Savior?YesNoUnsure Please explainPlease note that offers of admission may be revoked should additional information arise that indicates unlawful or unethical behavior.Criminal or Disciplinary Disclosure & Authorization to Release InformationBecause you indicated that you have a civil or criminal indictment, conviction, history and/or disciplinary action on this application, you will be asked to complete a background check once all of your application materials are received and processed.A previous disciplinary action, conviction, indictment or prosecution may not automatically bar an applicant from admissions to the university. We request that the applicant provide the Admissions Office permission to obtain a background check (at no cost to the student). By electronically signing below, the applicant authorizes Multnomah University to have complete access to pertinent educational, employment, criminal and civil information and records: Name: Date Signed: Please provide a complete and detailed explanation regarding any civil or criminal indictment, conviction, history and/or disciplinary action: Multnomah's Doctrinal StatementMultnomah University welcomes students from a variety of denominational backgrounds. The University holds to a short list of doctrinal articles. Though it does not require students to be in agreement with all points, it is important that you be familiar with the university’s doctrinal statement, found at www.multnomah.edu/about/doctrinal-statement. I have read Multnomah's doctrinal statement and I am confortable studying at an institution that holds to these positions.YesNo If not, please explain.Church Involvement Do you attend a church?YesNo What is the name of the church you attend? City, State DenominationPlease select...Non-DenominationalAmerican BaptistAssembly of GodAmerican Missionary FellowshipAnglicanBaptistBibleBrethrenCatholic BelieverCatholicConservative BaptistChurch of ChristCongregationalChristianChristian & Missionary AllianceCommunityCovenantEvangelical Church of North AmericaEvangelical FreeEpiscopalFree MethodistFriendsFoursquareGeneral Conference BaptistChurch of GodIndependentInd Fundamental Churches of AmericaInterdenominationalJewish BelieverJewishLutheranMennonite BrethrenMethodistNazarenePlymouth BrethrenPentecostalPresbyterianProtestant BelieverProtestantRegular BaptistRoman CatholicReformedSouthern BaptistSeventh Day AdventistUnknownVillage MissionsWesleyan MethodistCertification & Authorization $40 Application FeeI will pay my application fee now using a credit or debit card.I will mail a check or money order for my application fee.Other.You can mail a check or money order: Admissions OfficeMultnomah University8435 NE Glisan StreetPortland OR 97220You may pay your $40 application fee at https://www.multnomah.edu/payments. By submitting this application, I certify that I have provided complete and accurate statements on this application, and I waive my right to see reference forms that are submitted on my behalf. I understand that if it is found to be otherwise, this may be cause for rejection or dismissal. I understand that it is my right to be aware of the policies within the Student Handbook; I have read the Student Handbook and agree to abide by the policies, community standards, and values therein, as will be my responsibility as a student of Multnomah University.YesNoLinks:Mission StatementStudent Life Handbook Please type your full name in this box as a signature certifying the preceding statements are accurate and complete, to the best of your knowledge. Need assistance with this form?