Mountain Christian Church (MCC) Coursework: Application for Admission

Section 1: Personal Information

Name*

First Last

Date of Birth*

Social Security Number:*

This is a secure form. Your full SSN is required to process your application.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred phone*

Email*

I certify that all information given in this application to be correct and true. If I enroll, I pledge to uphold the Christian expectations and responsibilities for student lifestyles of Milligan University. I will conduct myself in a manner that will reflect positively upon my peers, the university, and myself. I consent to the use of my name and photograph in publications of Milligan University.

Please read the paragraph above and indicate your agreement by typing your full name.*

Prefix	Course Number	Course Title	Professor	Credits

Mountain Christian Church (MCC) Coursework: Application for Admission

Step 1 of 2

Section 1: Personal Information

Section Two: Admission Basics

Section Three: Course Enrollment

Section Four: Optional