Application Form

Have you ever taken courses at Hubbard College of Administration International before?
No    Yes   — If so, when?
BIOGRAPHICAL INFORMATION
Legal Name:
Prefer to be called:
Previous name(s), if any:
Mailing address (if different) effective until:	(yyyy-mm-dd)
Permanent Address: (Foreign Students must fill in foreign address)
Birth Date (yyyy-mm-dd):  Country of Birth
THE FOLLOWING QUESTION IS OPTIONAL PREDOMINANT ETHNIC BACKGROUND HUBBARD COLLEGE OF ADMINISTRATION INTERNATIONAL IS REQUIRED BY THE FEDERAL GOVERNMENT TO REPORT ETHNIC BACKGROUND INFORMATION ANNUALLY.
How would you describe yourself?
African - American (non-Hispanic)	Native American
Asian/Pacific Islander	Hispanic
White (Non-Hispanic)
Married Single Divorced Separated Widowed
Number of Children: #	U.S.A. Veteran: Yes No
U.S. Citizen: Yes No	Permanent Resident: Yes No
Visa: Yes No	Sex: Female Male
(How you will get to and from the College)
Public Car Walk
EDUCATION
High School Diploma: Yes No
Name of School:
College/University: 1 2 3 4
Degree:
Graduate/Professional: 1 2 3 4
Degree:
SPECIAL SKILLS
If you did not graduate from high school, do you have a GED? Yes No
Have you ever used financial aid for educational purposes? Yes No
EMPLOYMENT
Employer: Address:
Length of Service: Hours:
Work Performed:
Why are you considering a career in management or administration?
Do you have any practical experience in management or administration? If yes, describe:
What other schools have you investigated?
Have you ever applied for or received financial assistance? Yes No
Explain:
Foreign Student in Need of Student Visa (Only) How will you pay for your tuition and have living expenses while in the United States training?
Foreign Student in Need of Student Visa (Only) Can you show documentation to prove that you will be able to pay all expenses incurred while studying in the United States. Yes No
Who do you look to for support in making this decision?
Employer Parents Spouse Other
What obstacles, if any, could stand in the way of your attending Hubbard College of Administration International if you should be accepted?
Transportation Available Hours Child Care Vacation Interruption Prior Commitment Parent/Spouse Support Other (Please Explain)
What are your goals that Hubbard College of Administration International can help you achieve?
If family members have attended Hubbard College of Administration International, please list names, years of attendance and relationship to you.
OPTIONAL QUESTIONS
In order to assist us in meeting your individual needs, we request the following information.
A. Do you have a learning disorder that has been verified professionally?
Yes No      If yes, please explain:
B. Are you physically challenged?
Yes No      If yes, please explain:
EXTRACURRICULAR ACTIVITES
List your principal work, community, and family activities in the order of their interest to you. Include specific events and/or major accomplishments.
List all jobs (including summer employment) you have held during the past three years. Include the nature of the work, employer, dates of employment and number of hours per week
Special Honors and Awards list any special honors or awards you have received during the past three years.
Security Code:

Note: Changes are effected from time to time in the general regulations and in the academic requirements. There are, of course, established procedures for making such changes, which protect the individual student’s interests and the integrity of the school. A curriculum or graduation requirement, when altered, is not made retroactive unless the alteration is to the student’s advantage and can be accomplished within the span of time normally required for graduation.

Hubbard College of Administration International admits students of any race, color, creed, sex, handicap, national and ethnic origin to all rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, creed, sex, handicap, national, or ethnic origin in administration of its educational policies, admission policies or other school administrative programs.