Application Form <<|>> American Indian College

Application Instructions

An application to American Indian College consists of:

The completed application form, including additional explanations where required.
An official transcript from your high school or GED center, and other academic institutions attended beyond high school.
Pastor's reference.
A signed statement of Christian student responsibilities. Download our Student Standards of Conduct for signing and submission.
SAT or ACT test scores.

All documents should be in the Admissions Office four weeks before classes begin. Your application can only be precessed by the Admissions Committee when a complete file is received containing the 5 above listed items. Once your completed application is received, your application will be processed by the Admissions Committee. If you have any questions about your application, please call toll-free at 1-800-933-3828.

Please send all admissions materials and correspondence to:

Office of Administration
American Indian College
10020 N. 15th Avenue
Phoenix, Arizona 85021-2199
(602) 944-3335 | 1-800-933-3828

Personal Information

First name:

Last name:

Middle name:

Gender:

Male
Female

Address:

City:

State:

Zip:

Home Phone:

( ) -

Day Phone:

( ) -

Date of Birth:

/ /

E-mail:

Social Security #:

- -

Tribal Affiliation:
(Enrollment)

Ethnic Origin:

White (non-Hispanic)
Black (non-Hispanic)
Hispanic
Asian or Pacific Islander
American Indian/Alaska Native
           If American Indian, specify tribe(s):

Other (specify)

Marital Status:

Married
Widowed
Single
Divorced
Separated

If married, have you or your spouse been divorced?

Yes
No
If yes, please briefly explain below:

Name of spouse:

Names and ages of your dependent children (one per line, please):

How did you first hear about American Indian College?

Are you a veteran?

Yes
No

Are you eligible for VA benefits?

Yes
No

Address of parent or nearest relative (other than spouse) that AIC may notify in case of emergency:

First Name:
Last Name:
Middle Name:
Phone:	( ) -
Address:
City:
State:
Zip:

Application Information

Application for:	Fall 20 Spring 20
Admission Status:	Freshman Transfer
I plan to attend AIC:	Full-time Part-time
Are you seeking a degree from AIC?	Yes No
Area of academic interest:	Bachelor of Arts in Elementary Education Associate of Arts in Business Bachelor of Arts in Christian Ministry (Choose One Concentration) Church Ministries Christian Education and Youth Ministry Intercultural Ministries Bible
What is your career goal?
Please list 3 reasons why you chose to apply to American Indian College:
1. 2. 3.
What other colleges or universities are you considering applying to? (Please list these institutions in the order of preference and include AIC):
1. 2. 3. 4.
Do you wish to be considered for financial aid?	Yes No
If you wish to be considered for financial aid, please submit a Free Application for Federal Student Aid (FAFSA).
I have/will submit a FAFSA on (Date):	/ /
Have you applied for a tribal scholarship?	Yes No

Educational Background

High School Diploma
GED
College/University

High School Name:

City:

State:

Date Graduated:

/ /

Date GED Passed:

/ /

Other Schools and Colleges or Universities Attended:

Name	City	State	Credits	Degrees	Enrollment Dates
1.
2.
3.

Scholastic Honors/Awards:

Church Information

Church Name:
Church Phone:	( ) -
Address:
City:
State:
Zip:
Denomination:
Pastor's Name:

Christian Experience

How long have you been a Christian?

Please give a brief account of how you became a born-again Christian:

Do you feel the call to some Christian ministry or service? Explain:

Pastor's Reference

Name:
Phone:	( ) -
Title/Position:
Church:
Address:
City:
State:
Zip:

Employment & Experience Information

Non-church related:

Employer	Your Position	Location of Company	Employment Dates

Church related (include all paid and volunteer positions, committees, services and activities during the past five years):

Name of Church or Church-related Institution	Your Position	Location	Dates	Paid or Volunteer?

Special Consideration

Have you ever been dismissed from school or placed on academic or disciplinary probation?	Yes No
Do you have any physical handicaps which might require special consideration from the college?	Yes No
Have you ever used tobacco, alcohol or illegal drugs?	Yes No
Have you ever received professional care for emotional problems? (If yes, please include name, address & phone number of your caregiver in your explanation below.)	Yes No
Have you ever been convicted of a crime?	Yes No
Have you ever been in jail?	Yes No
If you checked "yes" to any of the above, please explain below, including dates.

Personal Statement

Statement: My initials below affirm that I am in agreement with the mission and puroses of the American Indian College of the Assemblies of God. I certifty that the answers in this application are correct to the best of my knowledge and belief. I understand that any failure to fully disclose all required information may void my application. I further understand that any subsequent determination of dishonesty in the application will be grounds for dismissal from the college.

Date: / / Initials:

10020 N. 15th Ave., Phoenix, AZ 85021-2199 | (602) 944-3335 | Fax (602) 943-8299