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Applicant Personal Information

Legal Last Name*

First & Middle Name*

Maiden or Other Name(s) Used

Birth Date*

Sex

Address*

Street Address City State ZIP Code

Home Number

Cell Number*

Work Number

Email*

Country of Citizenship*

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Program Information

Program of Interest*

Preferred Schedule

Education Data

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Parent/Guardian or Spouse Information

Legal Last Name

Legal First Name

Relationship

Cell/Home Number

Address

Street Address City State / Province / Region ZIP / Postal Code

Emergency Contact Information (Other Than Parent)

Legal Last Name

Legal First Name

Relationship

Cell/Home Number

Address

Street Address City State / Province / Region ZIP / Postal Code

Today's Date*

Signature*

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Consent*

I hereby acknowledge that I am making an application to apply for admission at Fremont University and have received an application packet. The application packet fee is $25.00 and is non-refundable. I understand that receiving this material does not obligate me to attend Fremont University, nor does this guarantee that I will be accepted to Fremont University.

On the next screen you’ll have the option to pay the $25 application fee today with a credit card or choose to pay later by phone or with cash.

Fremont University Application

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Program Information

Education Data

Parent/Guardian or Spouse Information

Emergency Contact Information (Other Than Parent)

Application Fee

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