PART-TIME APPLICATION

Thank you for your interest in Kuyper College! Please fill out this form and return it to the Admissions Office with a copy of your high school/college transcripts and a $20 registration fee. Most Kuyper College classes are three (3) credit hours.

I would like to (choose one):

Audit(course recorded on transcript as “AU”; no grade recorded). $410 per credit hour.

Dual Enroll(course recorded on both high school and college transcript). $190 per credit hour.

Permission to Take Classes(course and grade recorded on transcript). $950 per credit hour.

You may take a maximum of six (6) credit hours under this status.

Personal Enrichment*(course and grade not recorded on transcript). $200 per course.

*High school/college transcripts and $20 registrationfee are NOT required. After approval, please pick up your class pass at the Academic Office.

I wish to enter Kuyper: Fall – September 20____ Winter – January 20____ Spring – May 20____

Name: ______

Address: ______

City: ______State: ______Zip: ______

SSN# ______Country of Citizenship: ______

Birth Date: ______E-mail address: ______

Home Phone: ______Cell Phone: ______

High School/College Attended: ______Graduation Date______

Emergency Contact Information

Name: ______Relationship to You: ______

Phone: ______E-mail address: ______

Optional

Denomination: ______Church: ______

Gender: ______Ethnicity: ______

CHRISTIAN CONDUCT AND WITNESS:

Kuyper College expects all students, staff, and faculty members to honor the Lord in all they do, to love him with their hearts, minds, and strengths, and to love their neighbors as themselves. The goal of the College and of each individual is to follow Jesus Christ and serve him. For this reason, everyone is urged to avoid activities that displease Christ in any way or impair the testimony of the person or the College. The primary guidelines for life are found in God’s word. What scripture expects of Christians (morality, honesty, kindness, Christian responsibility and freedom, etc.) is our expectation for student behavior as well. Kuyper College reflects a diversity of theological beliefs and practices and promotes free discussion of theological issues, but not the imposition of these differences on fellow students and staff. For more information, the Student Handbook and Statement of Faith are online at I certify that the information on this application is, to the best of my knowledge, accurate. I also subscribe to Kuyper College’s Statement of Faith and the statements of Christian Conduct and Witness. I agree to honor and respect differences of theological beliefs and practices as I interact with others, and I agree to observe the rules governing student conduct as found in the Student Handbook.

Applicant SignatureDate

Please mail this form, high school/college transcripts and registration fee to Kuyper College Admissions Office

3333 East Beltline Ave. NE, Grand Rapids, MI 49525 / Questions? Call 616-988-3632