After reviewing the Computer-related Requirements for Online Programs Please print this form, fill out, and return with supporting documents to:
Office of the Registrar, World University,
P.O. Box 1567, Ojai, CA 93024-1567 USA.
(Use checklist at end of form to make sure all items have been included.)

1. Program or course name: ____________________________________

2. Applying for: [__]Fall   [__]Winter   [__]Spring   [__]Summer  200___

3. Legal Name:

First:___________________________   Middle Initial: _____

Last:___________________________

4. Current Address:

Street:_______________________________________

City: _________________________________________

State or Province: _______________________________

Zip or Postal Code: ______________________________

Country: ______________________________________

5. Permanent Address:

Street:__________________________________ _____

City: _________________________________________

State or Province: _______________________________

Zip or Postal Code: ______________________________

Country: ______________________________________

6. E-Mail: __________________________________________

7. Telephone:

Work: _(____)__________________________

Home: _(____)__________________________

8. Occupation: ____________________________________________

9. Professional License (if any).

State: ____________________________________

Title: _____________________________________

License Number: ____________________________

10. Social Security Number: _______________________________

11. Birthdate: _________________________________________

12. Place of Birth: ______________________________________

13. Citizenship: ________________________________________

14. Residence status if living in US and not U.S. citizen: _______________

15. Gender: F [__]    M [__]

16. Ethnic Background (please check one):

[__] Asian/Pacific Islander     [__] Black/African American
[__] Hispanic/Latino/Chicano [__] Native American/American Indian
[__] White/Caucasian [__] Mixed Ethnicity[__] Other______________

17. Please enclose a recent passport-type I.D. photograph or photocopy of your driver's license (or passport photo page) with this application.

18. Please list the last high school and all colleges and universities attended and attach photocopies of all diplomas and professional licenses received. (Copies of transcripts, if available, may be submitted in place of copies of diplomas.)

____ Please check here if you graduated from a high school outside the United States or Canada, or received a GED certificate.

Institution           Location             Dates                      Credits/Degree

(high school)_________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

19. English:  Due to our location and the limits of our staff and funds, World University in Ojai currently offers instruction in English only. If you have not graduated from a high school or college in an English-speaking country, please provide evidence of your ability to read and write first-year college-level English. This should include an essay you have written, transcripts of English classes you have taken, and scores on English tests(if available).

I certify that the information I have provided is complete and accurate.

Signature: ____________________________________________

Date: ______________________________

20.  Personal essay: Please address the following topics and return with your completed application. Please be concise and limit your response to approximately 3 typewritten pages.

1. Background and life-changing/life-enhancing experiences.

2. Personal philosophy/spiritual practice.

3. Reason for seeking certificate or degree, and life goals.

4. Reason for applying to World University in Ojai.

5. How did you learn about World University in Ojai?

When this application and all requested materials are received and reviewed, applicant will be contacted to complete the application process.

Application Attachment Checklist.  I have included...

[__]  Photo of yourself (see item #17)

[__]  Copies of your diplomas or transcripts (see item #18)

[__]  If you have not graduated from high school or college in an
        English-speaking country, evidence of your ability to read and
        write English at the first-year college level. (see item #19)

[__]  Personal essay (see item #20)

Copyright 2001, World University in Ojai