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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) |
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| Indicate area in which you are applying for the Certificate:
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[ ] Criminal Justice |
[ ] Human Services |
[ ] Communications |
[ ] Religious Studies |
| [ ] Proof of HS graduation or GED attached (required) |
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Signature_______________________________________________________________________________
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| Make two copies: one for your records, and one to send to: |
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Assistant Director -- Registration
Adult and Professional Studies
Indiana Wesleyan University
4301 South Washington Street
Marion, IN 46953-5279
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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.
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