Biola_Catalog_19820101NA

Marital status (check): Single__ Married__ Number and ages of children ___________________

Date of marriage________ Separated or divorced (i ndicate date)________________

FAMILY BACKGROUND

Father's name__________________________ If deceased, when? __________

Where employed?________________________

Positio ~--------------

If father attended college, where? _________________________ Number of years_____

Mother's full name ________________________ If deceased, when? __________ (INCLUDE MAIDEN NAME) Where employed?________________________ Positio ~--------------

If mother attended college , where? ________________________ Number of years,_____

If parents are separated, give date of separation ______________________ If parents are separated, MONTH YEAR with whom do you live?---------------------------------------

Number of children older than yourself:

Brothers _____________ Sisters _____________

Number of children younger than yourself: Brothers _____________ Sisters _____________

Members of your family who have attended Biola ------------------------------

EDUCATIONAL EXPERIENCE

Anticipated (or past) graduation date from high schoo~---------------------------- MONTH YEAR Name of high school _________________________________________ Address of high school________________________________________ CITY STATE If you have been graduated from high school, list in chronological order your activities since high school graduation. (Schools attended, employment, military service, extended travel , etc.) Schools must be listed even though you do not expect transfer credit. Please include Biota extension courses, if applicable.

School, Work, Travel

Dates

Yes__ No__

Have you ever been dismissed or placed on academic or disciplinary probation?

If yes, explain the circumstances:

The Scholastic Aptitude Test (SAT) or ACT is REQUIRED , unless as.a transfer you will have sophomore status (requires a minimum of 27 accepted units). Please indicate the testing date on which you plan to take (or have taken) the: SAT ______________________or ACT ______________________ MONTH YEAR MONTH YEAR NOTE: Regardless of transfer status nursing majors and students seeking a teaching credential must take the SAT. 172

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