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APPLICATION FOR ADMISSION

School Site:

MAIL ALL APPLICATION FORMS TO:
Holy Patriot University
Admissions Office
7901 4th St. N. STE. 6424
St. Petersburg, FL 33702

IMPORTANT: Applications will not be processed nor academic standing be assessed unless all questions are answered and the application signed and dated by applicant. Do not leave any question blank. Put .N/A. if an item, such as a FAX number or email address, does not apply.

Personal Information

Name(Required)
Address(Required)
Birthday(Required)
Sex(Required)

EDUCATIONAL INFORMATION

(Attach Transcripts to this application)
High School(Required)
Previous College/ University
Previous College/ University
Previous College/ University
Previous College/ University
WHAT DEGREE/CERTIFICATE ARE YOU SEEKING(Required)

Non-Discrimination Policy:
HPU does not discriminate on the basis of nationality, ethnic origin, age, or gender. We guarantee the rights and privileges, and the availability of programs and activities to all students of the University.

Privacy Rights of Students:
STATUTE 20, UNITED STATES CODE, 1232g and regulations adopted pursuant thereto. The code provides for an institution to establish a category of student information termed directory information. All information, such as health and medical records, disciplinary records, records of personal counseling, required student and family financial income information records, transcripts or student permanent academic records, student placement records and other personally identifiable information shall be open for inspection only to the student and such members of the professional staff of the college as have responsibility for working with the student. Such information will not be released to second parties without consent of the student. Except as required for use by the president in the discharge of his official responsibilities as prescribed by laws, regulations of the state board, and board policies, the designated custodian of such records may release information from these records to others only upon authorization in writing from the student or upon a subpoena by a court of competent jurisdiction.

PLEASE READ CAREFULLY THE FOLLOWING AFFIDAVIT OF AGREEMENT BEFORE SIGNING(Required)
Accepted file types: jpg, png, pdf, Max. file size: 128 MB.
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Electronic Signature Agreement. By signing your name, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By signing you consent to be legally bound by this Agreement's terms and conditions. You also agree that no certification authority or other third-party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E- Signature or any resulting contract between you and Holy Patriot University.

To be paid via PayPal in the next screen to submit the application.