First Name

Middle Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

If you live in Illinois please select the county where you reside.

Country

Primary Phone Number

Email Address

Confirm Email Address

Demographic  Information

Gender

Marital Status

Birth Date

Ethnicity

Race (select all that apply)

Citizenship Status

Visa Type (if not a citizen of the United States)

Citizen of

Veteran

Have you ever served in the Armed Forces?

Which branch of the Armed Forces did you serve?

Discharge Date

Do you plan to draw from VA benefits while at Judson?

Personal

Social Security Number

What is your religion/denomination?

Do you regularly attend church?

Most Recent College

Enter most recent college information.

Name

City

State

Graduation Date

Second Most Recent College

Enter the second most recent college information.

Name

City

State

Graduation Date

Current Employment

Current Employer Name

Current Employer Address Line

Current Employer City

Current Employer State

Current Employer Zip Code

Current Employment Start Date

Current Employment Status

Current Supervisor

Current Employment Position

Previous Employment

Previous Employer Name

Previous Employer Address Line

Previous Employer City

Previous Employer State

Previous Employer Zip Code

Previous Employment Start Date

Previous Employment End Date

Previous Employment Status

Previous Supervisor

Previous Employment Position

NOTE: an academic year consists of 2 terms - the enrollment year 2024 includes both Fall 2024 and Spring 2025 semesters

When do you plan to start your studies?

In what academic year do you plan to start?

Do you plan to graduate from Judson University?

Will you apply for Financial Aid? (If "yes," please contact the Financial Aid Office for more information:847-628-2530.)

Will your employer provide financial assistance for degree study?

Please choose from these selections

If you are applying for the MBA program, indicate which concentration you intend to pursue

Which campus do you plan to attend?

Note: Rockford is only available to Counseling students. International students in the US on a student visa must choose a face-to-face location (Elgin or Rockford).