Continuing
Education Form |
| First
Name |
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Middle
Name |
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| Last
Name |
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Maiden Name |
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| Mailing Address |
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Street, City, Zip |
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| Telephone |
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Day Phone |
Evening Phone |
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| Fax Num. |
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Email |
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| Social Security |
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Age |
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| Birth Date |
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Gender
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| Country of Citizenship |
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If non-USA, type
of Visa |
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| Type of Resident |
Citizen
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Educational Background |
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| High School |
City/State |
Date of Graduation |
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| College
or University City/State
Dates Attended Major
Degree |
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| College or University
City/State
Dates Attended Major
Degree |
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| I want to take
Oxford Experience: |
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Cost: $3,495
$2,195
$2,195 |
One week Experience (Jul. 28th - Aug. 1st) 6 credit hours
One week Experience (Aug. 4th - Aug. 8th) 6 credit hours
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| How to Pay: |
| Please allow
one day for processing, then call (818) 779-8424 to pay
by VISA, Master Card, or Discover. If paying by check, send
immediately to The King's College and Seminary, ATTN: Student
Accounts, 14800 Sherman Way, Van Nuys, Ca 91405. |
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You are being allowed to sit in the above modular as
a Continuing Education (non-credit) student. If you desire
to take the modular for credit you must proceed with the
application process. Please call the Admissions office
at 818-779-8040. |
| Signature |
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Date
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