Indiana Wesleyan University
CERTIFICATE APPLICATION FORM

(Photocopies are accepted)

  Date ________________________________________
Name ______________________________________________ SS# _______________________________
Address _______________________________________________________________________________
City ________________________________________State ___________ Zip _______________________
Phone __________________________ Email Address __________________________________________
Note: All information on this form must be completed. No fee will be charged to submit this form.
How would you like your name to appear on the Certificate? (Please Print)
 

Indicate area in which you are applying for the Certificate:

[     ] Criminal Justice [     ] Human Services [     ] Communications [     ] Religious Studies
[     ] Proof of HS graduation or GED attached (required)

Signature_______________________________________________________________________________
Make two copies: one for your records, and one to send to:   Assistant Director -- Registration
Adult and Professional Studies
Indiana Wesleyan University
4301 South Washington Street
Marion, IN 46953-5279
Advantages of obtaining a Certificate:
  • Certificates allow elective requirements to be focused on specific career-oriented areas
  • The Certificate area will be noted on your grade transcript
  • Available to students in baccalaureate and associate programs, and to unclassified students
  • Certificates may be earned in more than one area

Guidelines for obtaining a Certificate:

  • Requires 15 credit hours from selected courses (See Bulletin or Electives Schedule)
  • 9 of the 15 credit hours must be taken at IWU (for degree-seeking students only)
  • A grade of C or better must be earned in each course

Contact your Student Services Advisor if you have questions.