Undergraduate Application Undergraduate Form 1Admissions2General3Education4Employment5Agreement AdmissionsLocation*OnlineMontgomeryBirminghamHuntsvilleMobileDegree Type*AssociateBachelorDegree Type*BachelorOnline - Bachelor Program*Biblical StudiesBusiness (BSB)Business Administration (BBA)Criminal Justice (EBCJ)HumanitiesCounseling PsychologyFire Science Management (FSM)Forensic PsychologyGeneral/Clinical PsychologyHealth & Rehabilitation PsychologyHuman Resource Management - (HRM)Sports PsychologySLP Leveling Courses (Non-Degree)Online - Associate Program*Associate of Art in Liberal ArtsAssociate of Science in Liberal ArtsComputer & Information ScienceMontgomery - Bachelor Program*AccountingBiblical StudiesBiochemistryBiologyBusiness Administration - Daytime ProgramComputer EngineeringComputer and Information ScienceComputer ScienceCounseling PsychologyCriminal Justice - BCJ Accelerated ProgramCriminal Justice - Daytime ProgramElementary EducationEnglishExercise ScienceGeneral/Clinical PsychologyFinanceForensic PsychologyHealth and Rehabilitation PsychologyHealth Sciences - Daytime ProgramIndustrial/Organizational PsychologyInformaticsInterdisciplinary StudiesLegal StudiesLiberal ArtsManagementManagement Information SystemsMarketingMusicPhysical EducationSports ManagementSports PsychologyMontgomery - Associate Program*Associate of Art in Liberal ArtsAssociate of Science in Liberal ArtsLegal StudiesBirmingham - Associate Program*Associate of Art in Liberal ArtsAssociate of Science in Liberal ArtsLegal StudiesBirmingham - Bachelor Program*Counseling PsychologyCriminal Justice (BCJ)Forensic PsychologyGeneral/Clinical PsychologyHealth and Rehabilitation PsychologyIndustrial/Organizational PsychologyLegal StudiesSports PsychologyHuntsville - Associate Program*Associate of Art in Liberal ArtsAssociate of Science in Liberal ArtsLegal StudiesHuntsville - Bachelor Program*Counseling PsychologyCriminal Justice (BCJ)Forensic PsychologyGeneral/Clinical PsychologyHealth and Rehabilitation PsychologyIndustrial/Organizational PsychologyLegal StudiesSports PsychologyMobile - Associate Program*Associate of Art in Liberal ArtsAssociate of Science in Liberal ArtsLegal StudiesMobile - Bachelor Program*Counseling PsychologyCriminal Justice (BCJ)Forensic PsychologyGeneral/Clinical PsychologyHealth and Rehabilitation PsychologyIndustrial/Organizational PsychologyLegal StudiesSports PsychologyEmphasis/Track/Concentration (Online - BSB)*Business ManagementHealth AdministrationLogistics ManagementEmphasis/Track/Concentration (Online - BBA)*Business ManagementHealth AdministrationLogistics ManagementNoneEmphasis/Track/Concentration (Montgomery - Biblical Studies)*Biblical TextMinistryYouth and Family MinistryEmphasis/Track/Concentration (Montgomery - Biology)*EnvironmentalGeneralPre-Medical/DentalPre-OptometryPre-VeterinaryPre-Physical TherapyEmphasis/Track/Concentration (Montgomery - English)*Composition and RhetoricCreative WritingLiteratureEmphasis/Track/Concentration (Online - Human Resource Management - (HRM))*None (Standard Program)Health AdministrationEmphasis/Track/Concentration (Montgomery - Physical Education)*No EmphasisPhysical Education Secondary Education Certification AreaEmphasis/Track/Concentration (Montgomery - Health and Rehabilitation Psychology)*None (Standard Program)Pre-Occupational TherapyEmphasis/Track/Concentration (Birmingham - Health and Rehabilitation Psychology)*None (Standard Program)Pre-Occupational TherapyEmphasis/Track/Concentration (Huntsville - Health and Rehabilitation Psychology)*None (Standard Program)Pre-Occupational TherapyEmphasis/Track/Concentration (Mobile - Health and Rehabilitation Psychology)*None (Standard Program)Pre-Occupational TherapyEmphasis/Track/Concentration (Montgomery - Health Sciences)*Physician AssistantSpeech Language PathologistPhysical TherapyOccupational TherapyTerm*October 16, 2023January 8, 2024Term*October 16, 2023January 8, 2024Term*January 8, 2024Term*October 16, 2023March 4, 2024Term*October 16, 2023January 8, 2024Term*October 16, 2023Term*August 2024Term*October 16, 2023January 8, 2024Term*August 21, 2023 GeneralName* First Middle Last Maiden Name Preferred Name Gender*FemaleMaleSocial Security Number* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County* Home PhoneCell Phone*Alternate PhoneEmail* Enter Email Confirm Email Emergency Contact Name Emergency Contact Phone NumberEmergency Contact Phone Number - AlternateAlternate Emergency Contact Phone NumberCitizenship*CitizenResident AlienNon-resident AlienEthnicity*HispanicNon-HispanicOpt OutUnknownRace*American Indian or AlaskanAsianBlack or African AmericanWhiteTwo or More RacesNative Hawaiian or Other Pacific IslanderUnknownCountry of Origin*United StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweDate of Birth*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Religious Preference*UnknownAdventistAfrican Methodist EpiscopalAssemblies of GodBaptistBuddhistChurch of the BrethrenChurch of ChristChurch of GodChristian Church(es)Christian ScientistDisciples of ChristEastern OrthodoxEpiscopalEvangelical FreeLatter Day Saints (Mormon)LutheranMennoniteMethodistMuslimNazareneNon-denominationalNo ReligionOtherPentecostalPresbysterianReformed (any)Roman CatholicShintoSociety of FriendsUnited Church of ChristChurch Name Do you plan to apply for financial aid?* Yes No Are you using VA benefits?* Yes No Are you a veteran?* Yes No Have you ever been placed on probation, suspended or dismissed from any educational institution (high school, college or law school, etc.) for ANY reason (including academic grounds or behavioral or disciplinary grounds, etc.)?* Yes No If you answered "yes" above, please explain in detail the circumstances.*Have you ever been arrested for any reason?* Yes No If you answered "yes," please explain in detail the circumstances, including all charges and their ultimate disposition.* EducationDid you graduate high school?* Yes No Last high school attended* Last high school attended location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Month/Year Graduated* Did you complete your GED?* Yes No Month/Year Completed GED* If you have attended school under another name (i.e. maiden name), please list below. Have you attended any colleges previously?* Yes No How many previous colleges?*123456789101.) Name of College* 1.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 1.) Did you graduate from this college?* Yes No 1.) Month/Year Graduated* 2.) Name of College* 2.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 2.) Did you graduate from this college?* Yes No 2.) Month/Year Graduated* 3.) Name of College* 3.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 3.) Did you graduate from this college?* Yes No 3.) Month/Year Graduated* 4.) Name of College* 4.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 4.) Did you graduate from this college?* Yes No 4.) Month/Year Graduated* 5.) Name of College* 5.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 5.) Did you graduate from this college?* Yes No 5.) Month/Year Graduated* 6.) Name of College* 6.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 6.) Did you graduate from this college?* Yes No 6.) Month/Year Graduated* 7.) Name of College* 7.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 7.) Did you graduate from this college?* Yes No 7.) Month/Year Graduated* 8.) Name of College* 8.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 8.) Did you graduate from this college?* Yes No 8.) Month/Year Graduated* 9.) Name of College* 9.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 9.) Did you graduate from this college?* Yes No 9.) Month/Year Graduated* 10.) Name of College* 10.) College Location* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State 10.) Did you graduate from this college?* Yes No 10.) Month/Year Graduated* EmploymentAre you currently employed? Yes No Is your company reimbursing you for tuition? Yes No Unsure Employer Name Department Position Work Phone Work Location City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State AgreementFaulkner University is a Christian university and as such has definite expectations about the conduct and character of those it admits as these matters have a definite impact on the spiritual and educational environment it is striving to create. Faulkner reserves the right to deny admission to or revoke the admission of anyone who has engaged in conduct that would, in its sole discretion, be detrimental to the educational and spiritual environment it is striving to maintain. Faulkner also reserves the right to deny admission to or revoke the admission of anyone who has engaged in conduct that would, in its sole discretion, lead the University to believe he or she would pose a risk of harm to persons on campus or would create safety concerns that would be detrimental to the campus environment.* I accept the codes of conduct above I understand that if I have misrepresented or failed to disclose any of the information requested on this application that the University reserves the right to deny my admission or to revoke my admission. I hereby certify that all information provided to Faulkner University is true, accurate, and complete. I agree that Faulkner University has my permission to verify all information relevant to my admission, including a criminal background check.* I certify the above statements are true EmailThis field is for validation purposes and should be left unchanged. Form has been tagged under:Application Skip back to main navigation
