Enrolment

Application Form

 

CHRIST’S UNIVERSITY IN PACIFIC

APPLICATION FOR ADMISSION

 

P.O Box 367, Nuku’alofa, TONGA (South Pacific)

New Student Admissions Information

Email: info@cup.edu.to

Office Phone: (+676) 28-125

  

Please print in pen or type all information

 

 

Legal name: Mr/Mrs/Miss ______________________   /___________________   /_________________     

                                                        Last (family name)              First name                                      Middle name                                                       

Male                       Female

 

Usually called: ______________________                                 Birth date: ________/________/________

                                                                                                                        Day         Month     Year

 

Mailing Address:  _________________________    /________________________ /___________________

                                                P.O Box (street)                                   City                                 Country

 

Telephone No: _______________________              E-mail address ___________________

 

Place of birth: ______________________

 

Citizenship:                           Tonga            New Zealand             Australia            USA    Other: ___________

 

Non-Tongan citizen: Are you a permanent resident?     Yes           No   If   yes, give Admissions

 

No:______________

 

Current marital status: (Circle all that apply)                      Married

 

Spouse’s full name: __________________

 

                Never married                      Widow or Widower                             Separated

 

                Divorced                                              Remarried                                               Single Parent

 

 

 

 

 

 

 

 

 

ADMISSION INFORMATION

 

Applying to attend:              University                

 

What level you’re entering? ___________ (Level 4, 5, 6, 7, 8, 9, 10)

 

Entrance date:                      Semester I ________________                         Semester II _______________________

                                                                                Year                                                             Year

 

Probable major: ____________________   (See list of Academic Degrees available and tick one box)

 

Certificates (L-4)                   Diploma (L- 5)                   Advanced Diploma (L-6)           Bachelor (L-7)

Postgrad Cert. (L-8)              Postgrad Dip. (L-8)          Master (L-9)                            Doctoral (L-10)

 

EDUCATION

 

Please list all Colleges, High Schools, institutes or technical school you have ever attended.  If you have attended more than two schools, submit additional information on a separate sheet.

 

Name of School: ____________________________                Dates attended: __________________

 

Degree received: _________________________

 

Mailing address: ______________________________________________________________________________

                                                P.O Box (or street)                               City                                         Country

 

Name of School: ____________________________                Dates attended: __________________

 

Degree received: ____________________________

 

Mailing address: _______________________________________________________________________________

                                                P.O Box (or street)                               City                                         Country

 

Do you expect to transfer credits from another university or institution?         Yes        No     (If yes, you must have another official copy of your transcript on file at Christ’s University in Pacific before these credits can be evaluated by the Records Office for possible transfer.  It is the applicant’s responsibility to request the forwarding institution to send an official transcript to Christ’s University in Pacific. Request forms are available in the Registrar’s Office).

 

FAMILY

Father’s name: _____________________________________                             Occupation: ___________________

                                (Indicate ‘Deceased’ if not living)

 

Permanent address: ___________________________________________________________________________________

                                                P.O Box (street)                                   City                                         Country

 

Mother’s name: _____________________________________                             Occupation: ___________________

                                  (indicate ‘ Deceased’ if not living)

 

Permanent address: ___________________________________________________________________________________

                                                P.O Box (street)                                   City                                         Country

 

Has any member of your family ever applied for admission or attended Christ’s University in Pacific?

 

                Yes           No

If Yes, give the names and relationship.

________________________________________________________________________________

 

________________________________________________________________________________

 

CONFIDENTIAL

 

Have you trusted (or accepted) Jesus Christ as your personal Saviour?                 Yes            No

 

When? ________________________________

 

Do you read the Bible daily?             Yes        No           Sometimes

 

Do you pray daily?                              Yes         No           Sometimes

 

Are you a church member?               Yes         No           Sometimes

 

Do you attend regularly?                  Yes          No           Sometimes

 

Denomination: _____________________   Pastor’s name: ________________________

 

Name of church: ____________________   Telephone no: _________________________

 

Check appropriate box:

 

Yes         No           Do you have or have you ever had any significant physical learning impairment

 

 

Yes         No           Have you ever been treated for any nervous, mental, or emotional disorder, or seen a Psychologist?

 

 

Yes         No           Have you ever used illegal or dangerous drugs?

Yes         No           Have you in any way used alcoholics’ beverages?

Yes         No           Have you used tobacco in any form?

Yes         No           Were you ever expelled, dropped, or suspended by any school or university?

Yes         No           Are you or have you ever been under the supervision of a parole officer?

Yes         No           Have you ever been arrested for any reason other than a minor traffic violation?

If any answer is affirmative, please give complete and accurate.  I also understand that I am financially responsible for the payment of this account if the student listed on the front of this application is accepted for enrolment.

I certify that the information given on this application is complete and accurate. I also understand that I am financially responsible for the payment of this account if the student listed on the front this of this application is accepted for enrolment.

Applicant’s signature: _______________________                                  Date: _________________

 

Signature of parent, guardian, or sponsor: ____________________________

 

BE SURE TO ENCLOSE YOUR T$100 APPLICATION FEE