Note: Please accept this signed form as authorization to send my official undergraduate reference to University of Fort Lauderdale.
* = Required Fields |
The Office of Admissions requires two references for applicants to our undergraduate programs. References must be outside of family members and must have known you for at least
one year. |
Students entering a business program must supply a professional reference and one of the following: academic reference, character reference, clergy reference. Students entering a ministry program must supply a clergy reference and one of the following: academic reference, character reference,
professional reference. |
| * = Required Fields |
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Date of Birth |
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| Last Name * |
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Country of Citizenship |
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| Mailing Address |
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Native Language |
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| City |
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Place of Birth |
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| Zip Code
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Social Security #
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| Are you a UFTL employee? |
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Gender Type |
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Yes
No |
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Male
Female |
| Are you a dependent UFTL employee? |
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Phone Number * |
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Yes
No |
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| Email Address |
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Work Number * |
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| Race/Ethnic Data:(Please select) |
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Please specify if other:
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| /// PREVIOUS EDUCATION |
| Name of High School * |
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Date Recieved MM/DD/YY*
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Diploma Received?
Yes
No |
| Mailing Address |
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If you have taken, or plan to take any of the following tests, indicate Date |
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GRE (Graduate Record Exam) |
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Date MM/DD/YY*
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GMAT (Graduate Admissions Test) |
| State |
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Date MM/DD/YY*
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| Zip Code
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LSAT (Law School Admissions Test) |
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Date MM/DD/YY*
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Other (please specify) |
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Date MM/DD/YY*
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| Planned semester of enrollment: |
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Do you expect to register as a full-time student? |
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Fall
Spring
Summer |
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Yes
No |
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Please specify your program of study: |
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| List ALL colleges and universities (last listed first) regardless of length of attendance or work completed. |
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| Have you previously registered for course work at University of Fort Lauderdale? If yes, please specify exact date of attendance: |
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Yes
No |
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Date Attended From
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Date Attended To
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| Please list any relatives who are UFTL students or alumni. |
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First Name |
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Last Name |
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| Church Affiliation |
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Address |
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| Pastor’s Name |
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City |
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State |
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Zip Code
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Do you have any physical disabilities?
Yes
No |
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| If yes, please explain>>> |
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| /// ACCEPTANCE AND SIGNATURE |
| By my signature, I agree to the conditions of this contract. I also agree that it is my responsibility to print a copy of this application for my records, complete an Enrollment Agreement and it is my responsibility to obtain a copy of the school's catalog. |
I certify that all information supplied by me in this application is correct and complete. I understand that any misrepresentation or falsification, including failure to report any college or university attendance, is sufficient cause for cancellation of enrollment and/or any credits earned from University of Fort Lauderdale. |
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