Washington Adventist University - Office of the Registrar 301-891-4119

Admissions Application for Special Student (Non-Degree Credit)

Please use your LEGAL NAME (no nick names)
Legal First Name : Middle Name : Last Name SSN
Address: Street Address City State Zip Code
Home Phone Cell Phone Date of Birth (MM/DD/YYYY)
Students Current Email :
How did you Hear about the Congress of Future Medical Leaders?
Have you Enrolled in WAU before?
If YES, date last attended (MM/DD/YYYY)
Demographic Data for Statistical Purposes

Racial /Ethnic Group Religion :

Department_ Course
Course Title
Credit Hours
Time of Meeting (Hours_Days)
Congress of Future Science and Technology Leaders
Sun - Tues
2016 SUM
Name of the Current School :

Tuition and fees for special courses and seminars are as announced by the coordinator of such programs. Payment must be made in full before class attendance.

Admission is granted without regard to race, sex, handicap, or national origin but is based on academic qualification. WAU expects every student to adhere to and respect the principles of Washington Adventist University and the standards of the Seventh-day Adventist Church. The student is responsible for learning these principles and regulations which can be found in the student handbook.

I hereby certify that the information I have given in this application is true and correct to the best of my knowledge, knowing that withholding or misrepresenting information may result in cancellation of my registration. By my signature, I pledge to uphold the ideals and standards as stated in the student handbook, if admitted as a student.
*The student’s valid email is needed in order to complete this application. Please note that all account information for this class will be sent to the given email.