Kentucky Christian University

Non-Degree or Provisional Student Application and Course Registration Form

First Name:

Last Name:

Address:

City:

State:

Zip:

Country:

Phone:

Email:

Birthday:

Use format: MM/DD/YYYY

Gender:

Marital Status:

High School Attended

High School Name:

H.S.City:

H.S. State:

Graduation Date or GED date and state:

Colleges/Universities Attended

College/University #1

Name:

City:

State:

Attended From:

Use Format: MM/DD/YYYY

Attended To:

Use Format: MM/DD/YYYY

Degree:

College/University #2

Name:

City:

State:

Attended From:

Use Format: MM/DD/YYYY

Attended To:

Use Format: MM/DD/YYYY

Degree:

College/University #3

Name:

City:

State:

Attended From:

Use Format: MM/DD/YYYY

Attended To:

Use Format: MM/DD/YYYY

Degree:

Course Registration Information

Please indicate the course(s) you wish to take

Course #1

Course Name:

Subject Code:

Course Number:

Location:

Term:

Year:

Course #2

Course Name:

Subject Code:

Course Number:

Location:

Term:

Year:

Course #3

Course Name:

Subject Code:

Course Number:

Location:

Term:

Year:

Course #4

Course Name:

Subject Code:

Course Number:

Location:

Term:

Year:

Transcript Release

I release a transcript of credits for this(ese) courses sent to the following organization:

Attention:

College/University/Company:

Address:

City:

State:

Zip:

Non-Degree/Provisional Student Conditions

Non-degree or provisional status will be granted to students who take twelve or fewer credit hours.
Non-degree students are those who DO NOT plan to pursue a degree at KCU; provisional students are those who DO plan to pursue at degree at KCU.
In order to pursue a degree at KCU, the student must complete the formal admission application process with the University.
Online courses may not be audited. A campus course taken as an audit (at half of the normal tuition rate) may not be converted to credit status after the last date to drop/add course in the term in which the course is taken. The balance of the tuition for that course will be due upon the request for change in status from audit to credit.
Students who wish to withdraw from the course must submit a properly completed withdrawal form to the Registrar's office. Refunds will the refund schedule published in the current University catalog.
A non-refundable $50 per course deposit is due with this form. Full payment of all tuition and fees is due prior to the first date of class.

Student type you are applying for:

Provisional

Non-degree

My name submitted electronically in the signature area below represents my signature and agreement to all terms and information above.

Signature:

Please type your full name.

Date:

Parent Signature:

If student is not 18 years of age.

A course deposit of $50 (with a $2 convenience fee) must be paid after submitting this form. After submitting this form click on the Make Payment button on the following page. You can also make a payment by contacting the Business Office at 606-474-3265.

Word verification: * Type the characters you see in this picture.

(verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.

Majors Offered by KCU

Advanced Biblical Studies
Bible and Ministry
- Emphases:
  - Camp Management
  - Christian Leadership
  - Missions
  - Preaching Ministry
  - Small Group Ministry
  - Youth and Family
Biology (Pre-Professional)
Business Administration
- Emphases:
  - Accounting
  - Management
  - Sport Management
Counseling Psychology
History/Pre-Law
Humanities
Music Business
Music Performance
Nursing
Social Work
Teacher Education
- Early Elementary (K - Gr. 5)
- Middle School (Gr. 5-9)
- Sec. English (Gr. 8-12)
- Sec. Social Studies (Gr. 8-12)
- Sec. Mathematics (Gr. 8-12)
University Studies
Worship

Non-Degree or Provisional Student Application and Course Registration Form

Academics Menu

Majors Offered by KCU