APPLICATION FOR
DISTANCE EDUCATION
TEACHER CERTIFICATION

Adult Degree Program

Southwestern Union Conference Teachers
SSL Certificate
 
  Complete the form and click next at end of form (no application fee required)
 
Double check all spelling and be as complete as possible.   
 
 

This off-campus program is only for Southwestern Union Conference Teachers.

Personal Data
Your Full Legal Name:
  
  Last Name (Family Name or Surname) First Name Middle Name Suffix
  
  First Name you prefer to be called Previous Last Name(s) Title

Date of Birth:      Gender:   Male     Female
  Month Day Year  

U.S. Social Security Number:   
     (This is a secure server, your personal information will be safe)

E-Mail Address:      FAX number:   
 (If available)  (If available)

Home Address:
 
 Number and Street (physical address) City State Zip Code Country (if not USA)

Phone Numbers:  
   Home Phone Cell Phone (if available) Work Phone

Mailing Address: (if different from Home Address)
 
 P.O. Box or alternative Number and Street City State Zip Code


Your Religion:  

Nation of Citizenship:           Nation of Birth:  

Ethnicity:
 Check which one applies. Your response is voluntary and will be used in a nondiscriminatory manner consistent with applicable civil rights laws
  Black or African American Native American or Alaskan Native Asian or Pacific Islander
  Hispanic White/Caucasian Other/Unknown

Southwestern Union Conference school where you are employed:  


Academic Information
When do you wish to start your attendance?   

Have you applied to Southwestern Adventist University before?     Yes     No
Have you attended Southwestern Adventist University before?     Yes     No

Which type of enrollment do you wish?
  For teacher certification only— elementary or secondary education
  To complete teacher certification as part of a SWAU degree— elementary education
  To complete teacher certification as part of a SWAU degree— secondary education


Academic History
Which one of the following academic classifications best applies to you at this time?
  Not Graduated from High School
  Graduated from High School, no college credit earned
  College Freshman (1−12 sem hrs)
  College Freshman (13−23 sem hrs)
  College Sophomore (24−55 sem hrs)
  College Junior (56−89 sem hrs)
  College Junior (56−89 sem hrs) with a previously earned two-year college degree
  College Senior (90+ sem hrs)
  College Senior (90+ sem hrs) with a previously earned two-year college degree
  Already have a four-year college degree


High School
 Name of High School (from which you graduated):
      
     City       State or Country
 Which of the following best applies to you?
  Graduated from High School Year:  
  Passed the GED or a state high school equivalency test   Year:  

List each College or University you have attended   (List each school one time only):
 
 School City State or Country Degree(s) earned Dates of attendance
 
 School City State or Country Degree(s) earned Dates of attendance
 
 School City State or Country Degree(s) earned Dates of attendance
 
 School City State or Country Degree(s) earned Dates of attendance
 
 School City State or Country Degree(s) earned Dates of attendance
 
 School City State or Country Degree(s) earned Dates of attendance

Please ask Colleges and Universities you have attended to send official transcripts to:

Admissions Office
Southwestern Adventist University
Keene, TX 76059

If you have completed less than 12 college hours, we will also need an official transcript from the last High School you attended.
If you took the GED, then we will also need an official GED Test Report



Student Pledge

By electronically submitting this application, I certify that the above statements are correct and complete.   I understand that incomplete or false information may make me ineligible for admission to or continuation at Southwestern Adventist University.