Enrollment Application

Interest

Your Interest

Campus

Name

First Name

Middle Name

Last Name

How did you hear about Herzing University

Contact Information

Email

Primary Phone

Secondary Phone

Best Time to Call

In order to process your application, we need to have accurate address information on file for you.

Country

Street Address

Address Line 2

City, State, ZIP code

City

State

ZIP Code

By clicking Next, I consent to Herzing University contacting me by phone (including mobile and manual/automated means), text, and email using the information I have provided.

Education

We need to gather some information from you regarding your High School, GED or Home School program. You may be required to provide a transcript to the college or a copy of your diploma, so please locate this document so it's ready when your admissions advisor asks for it.

High School Type

I am (or will be) a high school graduate

I hold (or will earn) a General Education Development Equivalency Diploma (GED)

I have (or will have) completed a home school program

Other

High School \ Institution \ Agency Sponsor \ Other

Student name when enrolled

GPA at graduation

Graduation year

We need to gather information about schools / colleges you may have attended. If you plan to transfer credits you must list the previously attended college.

College name

Country

City

Prior college experience

Degree (if any)

Graduation Year

Employment Information

Are you currently employed

Yes

No

Does your employer offer tuition reimbursment

Yes

No

I don't know

Current or former Employer

Position held

Start date

Work phone number

Street Address

Address Line 2

City, State, ZIP code

City

State

ZIP Code

Military Service

Active Duty, Retired, or Honorably Discharged

Yes

No

Your Branch of Service

Is your spouse active duty, retired, or honorably discharged?

Yes

No

Spouse's Branch of Service

Are you the dependent of someone who is on active duty or a veteran

Yes

No

Interest

Your Interest

Campus

Name

First Name

Middle Name

Last Name

How did you hear about Herzing University

Contact

Email

Primary Phone

Secondary Phone

Best Time to Call

Country

Street Address

Address Line 2

City, State, ZIP code

City

State

ZIP Code

Education

High School Type

High School \ Institution \ Agency Sponsor \ Other

Student name when enrolled

GPA at graduation

Graduation year

College name

Country

City

Prior college experience

Degree (if any)

Graduation Year

Employment

Are you currently employed

Does your employer offer tuition reimbursment

Current or former Employer

Position held

Start date

Work phone number

Street Address

Address Line 2

City, State, ZIP code

City

State

ZIP Code

Military

Active Duty, Retired, or Honorably Discharged

Your Branch of Service

Is your spouse active duty, retired, or honorably discharged?

Spouse's Branch of Service

Are you the dependent of someone who is on active duty or a veteran

By submitting this form, I understand that this is a step and not acceptance into Herzing University. Admittance is subject to university review and approval. Moreover I may be asked to again provide this or additional information. By submitting this form, I consent to Herzing University contacting me by phone for marketing messages (including mobile and manual/autodialed means), text, and email using the information I have provided. I understand that my consent is not a condition of enrollment.

Enrollment Application

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