Application for Enrollment

Apply to 91��

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Personal Information

Unique ID

Name*

Email Address*

Home Phone*

Birth Date*

Gender*

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Age

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Mailing Address

mailing address*

Is in the U.S.

Is in Canada

Is outside the U.S. and Canada

Address*

Citizenship

Citizenship Status*

U.S. Citizen

Non U.S. Citizen

Permanent Resident

Do you plan to apply for financial aid?*

Yes

Social Security Number

Used to match FAFSA information

Currently living in the U.S.*

Yes

Current Visa Type*

Country of Citizenship*

Country of Birth*

City of Birth*

Do you anticipate needing F-1 student status during your enrollment?*

Yes

Ethnicity

Race*

Select all that apply:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Prefer Not to Report

Are you Hispanic/Latino?*

Yes

91�� collects ethnicity information for statistical purposes only. Ethnicity is not considered in admissions or financial aid decisions.

Military and First Responder Affiliation

Do you currently work as a firefighter, EMS worker, rescue volunteer or a member of law enforcement?*

Yes

Are you affiliated with the US military?*

Yes

Military Affiliation*

Branch of Service*

Do you intend to use GI funding from the U.S. Department of Veterans Affairs?*

Yes

Do you intend to use your own benefit or a benefit transferred from a spouse or parent?*

Self

Spouse/Parent

Please select the type of VA Benefit that you intend to use.*

Have you ever been subject of a court martial or dishonorably discharged from the military?*

Yes

Academic Plans

Would you like to study on campus or online?*

On Campus

Online

Degree Type*

Program of Interest*

Concentration*

Concentration

NOTICE: Due to new federal regulations enacted as of July 2024, we are currently only accepting nursing students who live in Virginia. If you do not live in Virginia, but plan to move to Virginia or intend to complete your practicum in Virginia, please reach out to our Office of Admissions to further discuss prior to submitting an application.

For which program are you completing Undergraduate Preparatory Coursework?*

Acknowledgement of State Licensure Requirements*

By checking this box I indicate that I have read and understand the following:

You have selected a program designed to lead to initial licensure or certification. Academic requirements for licensure are determined independently by each state. Federal regulations require 91�� to collect the following information for programs leading to initial licensure. Please answer to the best of your knowledge.

Please indicate the state in which you intend to become licensed and practice your occupation after completing your licensure program.*

Acknowledgement of Blended-Campus Degree Program Disclosure*

By checking this box I indicate that I have read and understand the following:

As an on-campus undergraduate student, I agree to enroll in a blended-campus bachelor’s degree program with major courses instructed online. I understand that I may be required to take general education courses on campus in a face-to-face classroom. I understand that all major courses in my online program are only offered online. I understand that 91�� does not provide face-to-face instruction for the major courses in my blended-campus program. I agree to pay on-campus tuition and fees for all courses, regardless of on-campus or online instruction modality. As an on-campus student, I understand that I may choose to live on campus, I may be required to take general education and elective courses on campus, and I will be encouraged to participate in athletics, campus ministries, or student life activities on campus.

Earlier in this application, you provided your mailing address. Do you intend to be in this same state during your first semester of coursework in your licensure program?*

Yes

Please indicate which state you intend to be in during your first semester of courses.*

Do you intend to take online courses in your first semester of your licensure program?

Yes

Acknowledgement of Program Outcomes*

By checking this box I indicate that I have read and understand the following:

91��’s B.A. in Law, M.A. in Law, and M.A. in Financial Planning and Law programs do not lead to the practice of law. These programs are designed for students seeking law-related careers that are open to non-attorneys. These programs do not qualify graduates to sit for the bar exam in any jurisdiction.

91��’s B.A. in Law, M.A. in Law, and M.A. in Financial Planning and Law programs do not provide consideration for preferred or guaranteed admission to the JD program. Students interested in later pursuing a JD must fulfill all required JD application requirements. Academic credit is not transferable from the B.A. in Law, M.A. in Law, or M.A. in Financial Planning in Law programs to the JD program.

Acknowledgement of Non-Licensure*

By checking this box I indicate that I have read and understand the following:

The program to which I am applying is not designed to prepare for licensure in any state. Earning this degree will not prepare graduates to sit for licensure examinations or pursue licensure or certification during or after degree conferral. This program is designed for those seeking a non-licensure career path.

When would you like to start?*

Start Term*

No start dates are available. Please contact our Office of Admissions.

Please tell us about your previous fine arts experience (education, involvement in extracurriculars, ministry/church, and formal groups):*

Regent’s Early College Program

Would you also like to submit an application to Regent’s Early College Program? If yes, please indicate your desired start date:

Interested in Regent's Honors College?

Please check the box below to express your interest and learn more. Note that the Honors College has a separate admissions process, including the following requirements: 1) A cumulative high school GPA of 3.7 or higher (students with a slightly lower GPA may be considered if other admissions criteria are strong). 2) Submission of an ACT, SAT, or CLT test score.

Yes, I am interested in applying to Regent’s Honors College.

Academic History

What is your high school graduation status?*

High School Graduation Year*

High School Graduation Month*

What Year Did You Complete Your GED?*

Please indicate the state where you completed Your GED*

Have you completed credit(s) at the college level after high school?

Yes

High School Attended*

Search and select the most recent high school you attended in the box below. If your school is not found in the search, type its full name and press ‘Enter’ or tap/click Add… below.

Legal Name During High School*

How many college credits have you completed after high school?

Please enter a number greater than or equal to 1.

Have you previously been enrolled at Regent and received a grade (including a W)?*

Yes

Are you applying to the same program in which you were previously enrolled, but did not graduate?*

Yes

Acknowledgement of Student Record Reactivation Requirement

By checking this box I indicate that I have read and agree to the following:

If your previous student record went inactive, 91�� may require you to take one credit bearing course (1-3 credits) to reactivate your student record; this is explained in the University Catalog. Additionally, if you are readmitted to 91��, you may need to complete a SAP (Satisfactory Academic Progress) Appeal in order to be eligible to pursue Financial Aid through the FAFSA process.

Have you earned grades at any other schools since you last attended Regent?*

Yes

Have you completed or are you currently completing an undergraduate degree?*

Yes

You have selected a program that requires an undergraduate degree. If you do not have a conferred undergraduate degree or are not within one year of graduating with an undergraduate degree, please choose a different program.

Have you completed credits at the graduate level?*

Yes

College(s) Attended*

Search and select all colleges attended in the box below. If your school is not found in the search, type its full name and press ‘Enter’ or tap/click Add… below.

Are you able to upload unofficial transcripts from your most recent school attended (required for admission to Regent)?*

Yes

Upload Transcript File(s)*

Drop files here or

Accepted file types: jpg, png, doc, docx, pdf, Max. file size: 5 MB, Max. files: 5.

Please note that unofficial or official transcripts are required from all schools prior to acceptance at Regent. After submission, you will be forwarded to the Transcript Request Form to provide 91�� permission to attempt to request official transcripts on your behalf.

Please note that unofficial or official transcripts are required from all schools prior to acceptance at Regent. You will be provided a personalized URL via text and email upon application submission to provide your remaining documents.

Are you able to upload your unofficial college transcripts (required for admission to Regent)?*

Yes

Upload Transcript File(s)*

Drop files here or

Accepted file types: jpg, png, doc, docx, pdf, Max. file size: 5 MB, Max. files: 5.

Are you able to upload your unofficial high school transcript (required for admission to Regent)?*

Yes

Upload Transcript File(s)*

Drop files here or

Accepted file types: jpg, png, doc, docx, pdf, Max. file size: 5 MB, Max. files: 5.

Are you able to upload your unofficial college transcripts from your most recent degree obtained or last school attended (required for admission to Regent)?*

Yes

Upload Transcript File(s)*

Drop files here or

Accepted file types: jpg, png, doc, docx, pdf, Max. file size: 5 MB, Max. files: 5.

What is your cumulative GPA from your Undergraduate degree?*

Please enter a number less than or equal to 4.00

What is your cumulative GPA from your most recent school attended?*

Please enter a number less than or equal to 4.00

Parent/Guardian Information

First Parent/Guardian Name

First Parent/Guardian Relationship to You

First Parent/Guardian Phone

First Parent/Guardian Email

First Parent/Guardian Highest Level Education Achieved

Second Parent/Guardian Name

Second Parent/Guardian Relationship to You

Second Parent/Guardian Phone

Second Parent/Guardian Email

Second Parent/Guardian Highest Level Education Achieved

Parent/Guardian Information

First Parent/Guardian Name*

First Parent/Guardian Relationship to You*

First Parent/Guardian Phone*

First Parent/Guardian Email*

First Parent/Guardian Highest Level Education Achieved*

Second Parent/Guardian Name

Second Parent/Guardian Relationship to You

Second Parent/Guardian Phone

Second Parent/Guardian Email

Second Parent/Guardian Highest Level Education Achieved

Supplemental Questions

Do you currently have an overdue balance at another college or university?*

Yes

How much is owed?*

$1-$1,000

$1,001-$5,000

$5,001+

Are you actively enrolled in a payment plan to address hold or balance?*

Yes

Have you ever been convicted of a crime other than a minor/traffic or juvenile offense?*

Yes

Upon submission you will receive an email directing you to provide further explanation on your response.

Are there any criminal charges pending or expected to be brought against you?*

Yes

Upon submission you will receive an email directing you to provide further explanation on your response.

Have you ever been on academic/disciplinary or conduct related probation or been dismissed from any educational institution?*

Yes

Please select which type of academic standing.*

Academic Probation

Academic Suspension

Academic Dismissal

I am comfortable learning from a Christian perspective.*

Agree

Disagree

I will respect other students' points of view and perspectives even though I may disagree with them.*

Agree

Disagree

Considering your personal, spiritual and professional background, why have you chosen 91�� as the place to pursue your degree?*

Which standardized test(s) have you taken?

SAT

ACT

CLT

SAT Score*

Please enter a number from 400 to 1600.

ACT Score*

Please enter a number from 1 to 36.

CLT Score*

Please enter a number from 0 to 120.

Did you graduate from a Virginia Community College or Richard Bland College with an AA or AS Degree?*

Yes

Did you graduate from a North Carolina Community College with an AA or AS degree?*

Yes

Are you a homeschooled student?*

Yes

Have you graduated or will you graduate from a private school?*

Yes

Are you a member of the Phi Theta Kappa Honor Society?*

Yes

Are you a National Merit Semifinalist or Finalist?*

Yes

Additional Program Questions

What is your religious affiliation?*

Have you graduated with a bachelor's degree from one of the Council for Christian Colleges and Universities Members? To view a list of members, please visit cccu.org.*

Yes

Are you in full-time pastoral ministry?*

Yes

91��'s Statement of Faith says regarding the Trinity: "That there is one God, eternally existent in three persons: Father, Son and Holy Spirit." In the School of Divinity, our view of the Trinity is one that we discuss often and in-depth. Do you agree with 91��'s Statement of Faith regarding the Trinity?*

Yes

91��'s Statement of Faith says regarding the authority of Scripture: "That the Holy Bible is the inspired, infallible and authoritative source of Christian doctrine and precept." Do you agree with this statement?*

Yes

In 3-5 sentences, please share the details surrounding your testimony and making the choice to become a Christian.*

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Acknowledgement of Non-Licensure*

By checking this box I indicate that I have read and understand the following:

91��’s MA in Human Services, MA in Pastoral Counseling, MS in General Psychology, PhD in Counseling & Psychological Studies and non-degree/certificate programs do not lead to licensure. These programs are designed for those seeking a non-licensure career path. These programs are not designed for preparation for or licensure as psychologists, professional counselors or marriage & family therapists.

Additional Program Questions

Acknowledgement of Licensure Requirement*

By checking here, I certify that I understand that choosing to enter the K-12 Cognate area requires a copy of my current teaching license to ensure eligibility to pursue a Virginia K-12 Administration and Supervision endorsement.

Additional Program Questions

Acknowledgement of Licensure Eligibility Disclosure*

By checking this box I indicate that I have read and understand the following:

As you are seeking an education that will prepare you to become a future counselor or psychologist, we are obligated to evaluate your potential for success for obtaining a professional license. Your candid responses to the following questions will allow us to better advise you regarding your ability to obtain licensure. If you have a criminal history, you should be aware that it may adversely affect your ability to obtain a professional license. It may also restrict you from certain practicum and internship placements to whom such a history must be disclosed.

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Additional Program Questions

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Acknowledgement of Non-Licensure*

By checking this box I indicate that I have read and understand the following:

Additional Program Questions

Are you currently a registered nurse?*

Yes

Additional Program Questions

Acknowledgement of Licensure Eligibility Disclosure*

By checking here I indicate that I have read and understand the following: As you are seeking an education that will prepare you to become a future counselor or psychologist, we are obligated to evaluate your potential for success for obtaining a professional license. Your candid responses to the previous questions will allow us to better advise you regarding your ability to obtain licensure. If you have a criminal history, you should be aware that it may adversely affect your ability to obtain a professional license. It may also restrict you from certain practicum and internship placements to whom such a history must be disclosed.

Additional Program Questions

Do you want to pursue a career in teaching theatre?*

Yes

Do you want to pursue a career as a professional actor?*

Yes

Do you understand that there is an audition process for admission into this program?*

Yes

Certification

Signature*

Date

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91����

Apply to 91����

Personal Information

Mailing Address

Citizenship

Ethnicity

Military and First Responder Affiliation

Academic Plans

Academic History

Parent/Guardian Information

Parent/Guardian Information

Supplemental Questions

Additional Program Questions

Additional Program Questions

Additional Program Questions

Additional Program Questions

Additional Program Questions

Additional Program Questions

Additional Program Questions

Certification

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