PBU Undergraduate Admissions - Request for Information

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Information Request
Please note that this form is intended for applicants and students of our UNDERGRADUATE program only.
Complete the form in order to receive print literature about PBU or inquire about scholarship eligibility
for the upcomng school year. Please allow 7-10 days for your request to be processed. If you have any
further questions, please don't hesitate to give us a call at 800.366.0049 x4235.

* denotes required field

* Gender:	Male Female
* Full Name:
* Preferred Name:
* Address:
* City:
* State:	* Zip Code:
* Country:
* E-Mail Address:
* Re-enter E-Mail Address:
	Note: A valid e-mail address is required in order to guarantee the successful processing of this request.
* Phone:
* Date of Birth:	Month: Day: Year:
Present Level of Interest in PBU:	Low Moderate Strong High
I plan to enter PBU in:	Fall Spring Summer of Year: Other/Not Sure
As a:	Freshman Transfer
Anticipated resident status:	Resident Commuter
I initially plan to study:	Part-time Full-time
School Currently Attending:
Type of School Currently Attending:
Grade Point Average:
Test Scores:	PSAT SAT ACT Score:
I would like the following: (check all that apply)	To be contacted by an enrollment counselor via email To be contacted by an enrollment counselor via phone To receive print literature via the mail To inquire about scholarship eligibility
If you have any other questions or comments, please enter them here:
How did you first hear about PBU?
Please itemize extracurricular interests (sports,etc.):

Program(s) of Interest: (check all that apply)

School of Biblical Studies
Bible Ministries (transfer program)
Biblical Studies
Bible Enrichment (1-year)

School of Church & Community Ministries
Social Work
Camping Ministries
Children's Ministries
Church Ministries Interdisciplinary
Discipleship Counseling
Social Service Interdisciplinary
Missions Ministry
Pastoral Ministries
Pre-Seminary
Youth Ministries

School of Business & Leadership
Business Administration
Dual-level B.S./M.S.

Cooperative Programs
Computer- Application Develop. (A.A)
Computer- Networking Tech. (A.A.)
Computer- PC Support (A.A.)

School of Education
Dual-level B.S./M.S.
Elem./Early Childhood
Elementary
ESL/TESOL. Program
Health and P.E.
Bible Education
K-12 Music
Preschool-Kindergarten
Secondary English
Secondary Social Studies Citizenship and/or Social Science
Secondary Bible & History
Secondary Mathematics

School of Music/Perf. Arts
Bible w/ Church Music Minor
Church Music
Music Education
Performance
Composition

School of Lifelong Learning
ADVANCE Degree Completion
Institutes for Higher Learning

Special Programs
Institute of Jewish Studies
Israel Study Abroad Program
Wisconsin Wilderness Campus