Marshall University Regents Bachelor of Arts
 
 

Regents Bachelor of Arts Degree Application

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Regents Bachelor of Arts
Program Application
    Note: Please be sure to fill out this entire form.
       
 
Student ID Number:
  
     
 
Name:
Last
First
MI
 
   
 
Current Address
    
 
Street:
  
 
City:
  
 
State:
  
 
Zip:
  
 
   
 
Home Phone:
  ex. (123) 456-7890
 
Work Phone:
  
 
   
 
E-mail Address:
  
       
 

 

    
 
     Personal Data (This information is not required-used only for reporting)
 
   
 
Date of Birth:
    (MM/DD/YYYY)
       
  Martial Status:  
       
 
Gender:
  
 

 

    
 
Prior Education:
  



       
 
Other Education:  
  
       
 
     Please provide all previous Colleges attended and dates of attendance:

     (1) College/location/date

     (2) College/location/date

     (3) College/location/date

     (4) College/location/date

 
Present Employment
  

 
Employer:
  
 
   
 
Job Description or Title:
  
 
   
 
Employer's Address:
  
REASONS FOR PURSUING DEGREE (Check ALL that apply) REASONS FOR CHOOSING RBA PROGRAM (Check ALL that apply)













       
 

 

GOALS STATEMENT

Area of specialization, general area of study, or career for which you wish to prepare:

Have you ever been admitted to any other RBA Degree program in West Virginia?

 If yes, where?


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