Readmission Application

I wish to apply to:
NNU ID Number:
Title:
First Name
Last Name
Maiden Name
Permanent Address
Street
City	State Zipcode
Phone
Mailing Address
Street
City	State Zipcode
Phone

E-Mail
Date of Birth
Social Security Number
Marital Status:

Are you applying for financial aid? Yes No
I plan to take:
4 credits or less More than 4 credits I am a faculty/staff employee of the University
I have a Bachelors Degree from

Date Last Attended NNU :	Month: Year:
Expected to return to NNU:	Month: Year:

Schools attended since leaving NNU: (Students must request registrar(s) of any school(s) attended to send transcript(s) to NNU.)
Name of School (State & City)	Date From	Date To



If any year since leaving NNU is not accounted for above, list below your occupations and locations during such year(s).
Occupation	Date From	Date To


Curriculum: (Major or Interest Area)
If planning to teach, select one:	Elementary Secondary
If secondary is checked, list two teaching fields	1. 2.

If you are applying as a full-time student and three years have gone by since you last attended NNU, you will be expected to submit a current recommendation and health questionnaire. Forms will be sent to you upon receipt of your Application for Readmission.
I have been arrested for something other than a minor traffic violation:
If yes, please include a detailed explanation.

If admitted to Northwest Nazarene University, I agree to abide by the printed and announced rules which may be in force during my stay at the college; and if at any time my conduct and attitudes are in violation of those rules, I will voluntarily withdraw.

E-Signature: Please initial below to acknowledge that you reviewed the information above and agree that it is accurate. By initialing below, you endorse this document's legally binding in accordance to the E-Bill (S.761) and release the below initials in lieu of signature. Initial Here: