Non-Credit Admission Form
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Name : |
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(First-Name) |
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(M. I.) |
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(Last-Name) |
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Date of
Birth: |
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Social
Security No.: |
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(MM/DD/YYYY) |
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Mailing Address:
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Street: |
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City: |
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State: |
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Zip code: |
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Country: |
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Home
Phone : |
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Business Phone : |
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Email: |
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Application
for:
q Full Time q Part Time
Beginning in q Fall q Spring q Summer Year: 200__
Select
a program below:
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SAS
Training Program |
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Bioinformatics
Training Program |
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Oracle DBA Training
Program |
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CompTIA’s Network+
Training Program |
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CompTIA’s Security+
Training Program |
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Sun Java@ Training
Program |
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Digital Art Program
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Information
Technology Training Program |
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Other KSI
Program/Courses Please specify:
_____________________________________________________________ |
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q Certificate
Program in Computer and Information Sciences (CP)
Have you ever
applied for admission to KSI? q Yes q No If
yes, semester ________ year ______
Have you ever
previously attended KSI? q Yes q No If
yes, semester ________ year ______
How did you become interested in
KSI? q Friend q Alumni q Newspaper,
please specify:_____________
q Internet, please specify website
or search engine:_____________
q KSI Website q google.com q
gradschools.com
q Peterson’s Guide q Patterson q Other:________________
Are you a
foreign student? q Yes q No
Are you
applying for Financial Aid? q Yes q No
Statistical QuestionsV:
Sex: q Male q Female
Ethnic Origin: q (B) African
American q (A) American Indian or Alaskan Native q (W) Caucasian
q (H) Latin American q (P) Pacific Islander or Asian American q (N) Non-Resident
(I-20)
V This information is requested for purposes of Federal
Compliance Agencies only and will not be used in determining admission status.
Signature of Applicant:
____________________________ Date (MM/DD/YY): ___________
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Complete and return this form along
with $40 non-refundable, one-time
application fee. Please
make all checks payable to Knowledge Systems Institute |
Admissions
Office Knowledge
Systems Institute 3420
Main Street, Skokie, IL 60076 847-679-3135 847-679-3166
fax email:
office@ksi.edu http://www.ksi.edu |
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Office
use only:
Application
fee $40 paid: qYes qNo qCash qCheck #_______ |