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First Name (Surname)
Last Name (Given Name)
Preferred First Name (Nickname)
Spouse's First Name
Spouse's Last Name
Country of Present Citizenship
U.S. Citizenship Status
If you selected US Permanent Resident, please enter number:
In what city were you born?
In what country were you born?
The U.S. Department of Education has issued new guidelines for how institutions will collect and report race and ethnicity data. In order to respond to this request, we ask you to please respond to the following questions.
Race (Choose one or more)
Have you ever been convicted of a felony?
If yes, please explain the circumstances of your felony conviction.
Anticipated Academic Enroll Year
(Each year goes from August - July)
Anticipated Academic Enroll Term (Fall term is August - December, Spring term is January to early May, Summer term is May-June)
Name the first Course you want to take
Name of first Course you want to take:
Would you like to Audit this course or take it for Credit?
Name the second Course you want to take
Name of second Course you want to take:
Name the third Course you want to take
Name of third Course you want to take:
Other College/University where I am currently enrolled:
Permanent Home Mailing Address:
Do you reside outside of the United States?
Address Line 1
Address Line 2
County of Residence (if state is Kansas):
Primary Phone Number
Your Email Address:
Do you reside with your father?
Did your father attend Hesston College?
Father First/Given Name
Father Last Name (Surname)
Father Education Level
Father Primary Phone Number
Father Email Address:
Do you reside with your mother?
Did your mother attend Hesston College?
Mother First/Given Name
Mother Last Name (Surname)
Mother Education Level
Mother Primary Phone Number
Mother Email Address:
High School and College Information
Do you have a GED?
Name of Institution
City of Institution
State of Institution
High School or College/University?
High School Graduation Date:
High School GPA: