Online Undergraduate Application Checklist Online Undergraduate Application for Admission Save my progress and resume later | Resume a previously saved formResume LaterIn order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Page 1Online Undergraduate Application for AdmissionPlease complete this Application if it is your intent to take Multnomah classes solely in an online format.If you plan to take classes both in residence (i.e., on campus in Portland or Reno) and online, please complete the standard Undergraduate Application for Admission form. Admission forPlease select...August 2018 (Fall Semester, A Session)October 2018 (Fall Semester, B Session)January 2019 (Spring Semester, A Session) CampusOnline Desired MajorPlease select...Applied PsychologyBiblical and Theological StudiesBusiness ManagementHealthcare ManagementInformation Technology - CybersecurityInformation Technology - Application DevelopmentUndecided 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...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingOutside the United States State Zip CodeHidden Fields Student (Record Type) Constituent (Record Type) Household (Record Type) Educational Institution (Record Type)Page 2Additional 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 StatesCanadaAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas (the)BahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Antarctic TerritoryBritish Indian Ocean Territory (the)Brunei DarussalamBulgariaBurkina FasoBurmaBurundiByelorussian SSRCabo VerdeCambodiaCameroonCanton and Enderbury IslandsCayman Islands (the)Central African Republic (the)ChadChileChinaChristmas IslandCocos (Keeling) Islands (the)ColombiaComoros (the)Congo (the Democratic Republic of the)Congo (the)Cook Islands (the)Costa RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech Republic (the)CzechoslovakiaDahomeyDenmarkDjiboutiDominicaDominican Republic (the)Dronning Maud LandEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (the) [Malvinas]Faroe Islands (the)FijiFinlandFranceFrance, MetropolitanFrench Afars and IssasFrench GuianaFrench PolynesiaFrench Southern and Antarctic TerritoriesFrench Southern Territories (the)GabonGambia (the)GeorgiaGerman Democratic RepublicGermanyGhanaGibraltarGilbert and Ellice IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonal IslandsHoly See (the)HondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea (the Democratic People's Republic of)Korea (the Republic of)KuwaitKyrgyzstanLao People's Democratic Republic (the)LatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia (the former Yugoslav Republic of)MadagascarMalawiMalaysiaMaliMaltaMarshall Islands (the)MartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Midway IslandsMoldova (the Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlands (the)Netherlands AntillesNeutral ZoneNew CaledoniaNew HebridesNew ZealandNicaraguaNiger (the)NigeriaNiueNorfolk IslandNorthern Mariana Islands (the)NorwayOmanPacific Islands (Trust Territory)PakistanPalauPalestine, State ofPanamaPanama Canal ZonePapua New GuineaParaguayPeruPhilippines (the)PitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian Federation (the)RwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSikkimSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSouthern RodesiaSpainSri LankaSudan (the)SurinamSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan (Province of China)TajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos Islands (the)TuvaluUgandaUkraineUnited Arab Emirates (the)United Kingdom of Great Britain and Northern Ireland (the)United States Minor Outlying Islands (the)Unites States Miscellaneous Pacific IslandsUpper VoltaUruguayUSSRUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamViet-Nam, Democratic Republic ofVirgin Islands (British)Virgin Islands (U.S.)Wake IslandWallis and FutunaWestern SaharaYemenYemen, DemocraticYugoslaviaZaireZambiaZimbabwe Date of Birth GenderFemaleMale Do you plan to apply for financial aid?YesNo Are you an honorably discharged veteran of active duty in any branch of the US Armed Forces?YesNoCurrently Service Do you have special needs that Multnomah should be aware of to help you succeed?YesNoInformation shared here is confidential and will not be a factor in your admission decision Please help us understandEthnic & 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 decisionHousehold Will you be 21 or older when you begin your first semester?YesNo Marital StatusPlease select...SingleMarriedSeparatedDivorcedWidow/WidowerParent, Guardian or Spouse InformationStudents under the age of 21 are asked to provide information about their parents or guardians Relationship to youPlease select...MotherFatherGuardianSpouse First Name Last Name Phone Email Does this person share your mailing address?YesNo Mailing Address CityPlease select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip CodePage 3Academic History High School Year of high school graduationPlease select...2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950 High School Name City StatePlease select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingOther States Are you or will you be a home school graduate?YesNo Have you received, or will you receive, a GED?YesNo SAT & ACT I have taken or plan to take the SATI have taken or plan to take the ACTTest scores are not required for admission, but may help you qualify for an academic scholarship. Please note that SAT or ACT scores are an admission requirement for home school graduatesCollege Have you attended college or university?YesNo Institution Name City StatePlease select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingOutside the US Attended from: Attended to: Are you currently enrolled at this institution?YesNo Approximate Credits EarnedPage 4Lifestyle & 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 in any court?YesNo Do not include infractions such as speeding tickets. Please explainMultnomah'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 am a ChristianYesNo 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...NondenominationalApostolic or New ApostolicAssemblies of GodBaptistBorn AgainCatholicCharismaticChurch of ChristChurch of GodChurch of the BrethrenChurch of the NazareneCongregational/United Church of ChristDisciples of ChristEpiscopalian/AnglicanEvangelicalFoursquare GospelFundamentalistHolinessIndependent Christian ChurchLutheranMennoniteMethodist / WesleyanOrthodox (Eastern)PentecostalPresbyterianProtestantQuakerReformedOtherAcademic or Professional ReferenceMultnomah requires the submission of one Academic or Professional Reference form for the Undergraduate Online Program.You may not use a family member as your reference.Please provide the name and contact information for the individual you intend to use as a reference. By submitting this application for admission, you are waiving your right to see the reference form that is submitted on your behalf. If you provide an email address for your reference below, the Admissions Office will email him or her a link to the online reference form. Name First Name Last Name Phone Email Relationship to youPlease note: In some circumstances, we may ask for an additional reference. If this is the case, your admissions counselor will let you know and request the additional information. Reference AuthorizationBy providing this information I am authorizing Multnomah to contact the person listed above as my reference. I understand that the information provided by my reference will be used as part of the admission decision process, and I waive my right to review this information.Decision Factors How did you first hear about Multnomah?Please select...AlumniAdmissions CounselorCollege FairCo-worker or EmployerCurrent MU StudentFriendGuidance Counselor or TeacherGoogle SearchMU Faculty or StaffParent or RelativePastorRadioVisit to my high schoolWeb advertisementOther Explain What is the primary factor influencing your decision to apply?Please select...Academic Programs OfferedAcademic ReputationAdmissions CounselorAlumniBeliefs/ValuesCampus EventCampus VisitClassmateCollege FairCo-worker or EmployerFriendGuidance CounselorLocationMail or email communicationMU Faculty or StaffOther Explain Name of the person who referred you (so we can thank them)Certification & Authorization 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 respect 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. Save my progress and resume later | Resume a previously saved form Need assistance with this form?