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Program
for
Accelerating College Education |
HOUGHTON COLLEGE
P.A.C.E. APPLICATION Note: An applicant must be at least 25 years old and have about two years of college. |
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Please type or print.
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| PERSONAL FACTS |
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| ________________________________________________________________________________ Last Name First Name Maiden Name Middle Name |
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| ________________________________________________________________________________ Mailing Address: Number and Street City State Zip |
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Home Phone |
Work Phone |
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Fax Phone |
E-mail Address |
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Birth Date |
Social Security No. |
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| Country of Citizenship____________________ | _____Male _____Female |
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| (Optional Information) Ethnic background: _________Caucasian _________Native American |
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| _________Asian American _________Hispanic _________African American |
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| Marital Status:_____________________ Name of Spouse:________________________ | ||
| ACADEMIC HISTORY |
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| 1. List ALL post-secondary institutions (college, business, technical, etc.) attended and dates of attendance. (List CLEP tests separately). You must have completed 64 or more semester hours of college work before you will be enrolled into the program. _________________________________________ Dates______________________________ _________________________________________ Dates______________________________ _________________________________________ Dates______________________________ |
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| Estimated total number of credits earned: ____________ hours |
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| Did you receive an Associate Degree? ______________ Degree____________________________ |
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| Type_________________________________________ Date Graduated______________________________ |
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| Please forward copies of your transcripts with your application. 2. Military Education: Branch_____ MOS____ Currently in Active Reserves?_____ Please provide a copy of your DD214. |
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| EMPLOYMENT |
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| Describe your present employment. Job Title: ____________________________________________________________________ Current Employer: _____________________________________________________________ Address: ____________________________________________________________________ Dates: from: ____________________ to: ____________________ Full/Part Time Does your employer have an assistance program? __________ Please describe:____________ _____________________________________________________________________________ If yes, please provide a copy of your employer’s tuition assistance program. |
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| REFERENCES Please list two people who will be sending a letter of recommendation to the admissions committee. Write the name, address, position, and phone number of each below. 1. __________________________________________________________________________ _____________________________________________________________________________ 2. __________________________________________________________________________ Are you planning to apply for TAP/PELL/Stafford Loan? _____ Are you eligible for VA Benefits? _____ When do you prefer to begin classes? _____ Fall _____ Winter _____ Spring _____ Summer A $25 non-refundable application fee must accompany this application. ____________________________________________________________________________ Student Signature Date Houghton College admits students of any race, color, national or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the College. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, scholarships and loan programs, athletics and other school-administered programs. Houghton College is committed to compliance with Title IX of the Federal Education amendments of 1972. * PLEASE NOTE: If you are not a US citizen, send our office a copy of your visa or permanent residency status. |
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Have you. . .
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1. Requested that all college transcripts be sent to Houghton College? 2. Completed the application form? 3. Enclosed the $25 application fee? |
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Mail to:
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Houghton College 810 Union Road West Seneca, NY 14224-3425 Phone: 716-674-6363, ext. 8734 or 1-888-874-7223 |
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