NOTE: After you fill out this form, please print it and mail a copy along with your references and application fee.  Also mail your transcripts and a current photo. Or, if you push the submit button at the bottom of the page, you can just print out the reference forms from the PDF application and mail those in along with your application fee.

Personal Information

Institutional Interests

* Anticipated Enrollment:	Fall Semester Spring Semester May Term Summer I Summer II * Year:
Enrollment Status:	First Time Student Transfer Student Full-Time Part-Time
If Transfer Student, Year:
* Housing Plans:	Live with a family Commute from Home Rent with other students Need assistance finding housing Other (be specific):
* Financial Aid:	Yes, I am applying for financial aid No, I do not wish to apply for financial aid
If you answer YES to the above - You must complete our financial aid application and show a true need.
Degree Interest:	2 year Associate Degree 4 year Bachelor Degree Masters Audit Undecided
* Intended Major #1:	ADC Addictions Counseling BIL Biblical Studies CED Christian Education CIS Computer Application in Christian Ministry CMI Christian Ministries CMU Church Music DIV Divinity MIS Missions MWR Music - Worship PCC Pastoral Care and Counseling REL Religion/Philosophy SED Science /Creation Research SOC Sociology SWK Christian Social Work THE  Theology UND Undeclared YTH Youth Ministries
Intended Major #2:	ACC Accounting ADC Addictions Counseling AED Art Education ART Art ATH Athletic Training BIL Biblical Literature BIO Biology BAS Business Administration BIS Business Information Systems CED Christian Education CGR Computer Graphics - Art CHE Chemistry CIS Computer Info. Systems CMI Christian Ministries CMU Church Music COM Communication Arts CON Continuing Education CRJ Criminal Justice CRM Ceramics - Art ECO Economics EDS Special Education EED English Education ENG English FIN Finance HST History ILL Illustration - Art INT Intercultural Studies MAT Mathematics MUS Music MED Math Education MGT Management MKG Marketing MTE Medical Technology MUE Music Education MUS Applied Music PAT Pre-Art Therapy PED Physical Ed- Educatn Req PEL Pre-Elementary Education PHE Physical Education PHO Photography - Art PMD Biology Pre-Professional PNT Painting - Art POL Political Science PPL Pol. Science/Pre-Law PRN Pre-Nursing PSE Secondary Education PSY Psychology PRT Printmaking - Art PYC Primary Care Nursing REC Recreation Management REL Religion/Philosophy SED Science Education SOC Sociology SOS Social Studies SPA Spanish SPM Sports Management SSE Social Studies Education SWK Social Work UND Undeclared WRI Writing YTH Youth Ministries

Interests:

Men's Sports
HS C B N Baseball	HS C B N Soccer
HS C B N Basketball	HS C B N Tennis
HS C B N Cheer Team	HS C B N Track & Field
HS C B N Cross Country	HS C B N Golf

Women's Sports
HS C B N Basketball	HS C B N Softball
HS C B N Cheer Team	HS C B N Tennis
HS C B N Cross Country	HS C B N Track & Field
HS C B N Soccer	HS C B N Volleyball

Music
HS C B N Chorale/Worship	HS C B N Band
Instrument:
HS C B N String Ensembles	HS C B N Brass Ensembles
Instrument:

Communications
HS C B N Radio	HS C B N Television
HS C B N Drama	HS C B N Yearbook
HS C B N Newspaper

Family Background

Father or Legal Guardian's Name:	Living? Yes No
Telephone (If other than yours):	( )
Father's Address (if other than yours):
Father's Occupation:
Father's Employer:
Did your father attend college? (If YES, please state where)	Yes No Graduate? Yes No
Name of College:
Mother's Full Name:	Living? Yes No
Telephone (If other than yours):	( )
Mother's Address (if other than yours):
Mother's Occupation:
Mother's Employer:
Did your Mother attend college? (If YES, please state where)	Yes No Graduate? Yes No
Name of College:

If parents are divorced or separated, with whom do you currently live? Father Mother Other

Should be both mentioned when reporting college achievements? Yes No
Mother mentioned Father mentioned

Name of younger brothers and sisters living at the same address, and their year of high school graduation:

Name	H.S. Graduation Year
1.
2.
3.
4.

Academic Background

* Name of High School:
Address (Include city, state, and zip):
Telephone Number:	( )
Name of High School Counselor:
Dates of Attendance
(from) (to)
* Year of Graduation:

Date you took (or plan to take) The Scholastic Aptitude Test (SAT) or American College Test (ACT): Month: Year:
SAT ACT
Please request your high school to forward your high school transcript with SAT/ACT scores and G.P.A. (on a 4.0 scale) immediately.

Colleges or Universities Attended	Location	Date of Attendance From(mo/yr) To(mo/yr)	Hrs of Credit Attempted	Estimated Grade Point Average
1.
2.
3.
4.

Personal Information

* Have you personally accepted Jesus Christ as your Savior? Yes No
If YES, describe your relationship with Jesus Christ. Include a statement indicating how you came to such a commitment.
If NO, describe why the Christian emphasis at Coastland University appeals to you.

Name and address of hometown newspaper

Name:
Address:
City:	State:
Zipcode+4:

* Have you ever been arrested? No Yes
If yes, explain:

Community Values Expectations

Coastland University, as an evangelical Nondenominational Christian university, is a community joined together to further academic achievement, personal development, and spiritual growth. Together the community seeks to honor Christ by integrating faith, learning and living while its members' hearts and lives mature in relationship to Jesus Christ and to each other. With this purpose, please respond to the following questions regarding this community:

* 1. Are you committed to Christ as your personal Savior?	Yes No
Are you teaching or in ministry?	Yes No

Faith in God's Word should lead to behavior displaying His authority in our lives. Scripture teaches that certain attributes such as love, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control are to be manifested by members of the Christian community. By contrast, Scripture condemns such attitudes as greed, lust, needless anger, an unforgiving spirit, discrimination and prejudice.

* 2. Will you seek these positive attributes and avoid the negative attitudes in your life while at Coastland University?

Yes No

Futhermore, certain behaviors are expressly prohibited by Scripture. These include dishonesty in all forms (lying, stealing, cheating), impurity in speech (gossip, slander, profanity), sexual impurity (premarital sex, adultery, homosexual behavior) and substance abuse.

* 3. Do you agree to avoid these behaviors while attending Coastland University?

Yes No

Corporate worship aids in community behavior and support of the body of Christ. We gather as a community at special times for nurture and admonition in the things of God. These activities include chapel, spiritual emphasis week and other university related events. Chapel attendance is required for all resident students, as well as full-time commuting students under 23 years of age with classes before and after chapel.

* 4. Do you feel comfortable attending a university that has required chapel and has placed classroom prayer and other spiritual development opportunities as important priorities?

Yes No

Scripture teaches that all our actions (work, study, play) should be performed to the glory of God. We endeavor, therefore, to be selective in choices of entertainment and recreation, promoting those which strengthen the body of Christ and avoiding those which would diminish sensitivity to Christian responsibility.

* 5. Will you avoid unwholesome materials and entertainment in your life while attending CCBCU?

Yes No

It should be the goal of students at Coastland University to be above reproach.  This means that you will live your life as an example of Christ's love to those with whom you interact.  It is expected that students maintain a high standard of morality and Godly living at all times.

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Please send two recent pictures to, along with your transcripts and the $25.00 application fee to:
Admissions Office
Coastland University
P.O. Box 3371, Dana Point, CA. 92629
E-mail: admissions@ccbcu.edu

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I understand the personal conduct expectations and agree to abide by them. I certify that all the information contained in this application is correct, and that the opinions expressed are mine. Submitting this form indicates that I have answered the above questions truthfully and understand fully the expectations placed upon me as a student at Coastland University.

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