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Online Student Enrollment Application

Name :
 
Address :
 
City :
 
State :
 
Province :
 
Zip :
 
Country :
 
Phone :
 
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E-mail :
 
Date of Birth :
 
 
Place of Employment :
 
Work Phone :
 
Marital Status :
 
Sex :
 
If married, Spouse's name :
 
Your Objectives :
 
Educational Background :
 
Experience :
 
Professional Licenses / Certificates Held :
 
Books, Articles and/or Columns you have written (please explain) :
 
Military Experience/Volunteer Work :
 
How did you hear about KCNH?
 
Choose one of the four options below.
(1) Evaluation for: Degree Program(check only one)
 

(2) Evaluation for: 30 Hour Diploma Program (check only one)
 

 
(3) Evaluation for: 12 Hour Certificate Program (check only one)
 
 
(4) Evaluation for: School of Natural Animal Health Program* (check only one)
 
*Tuition is higher than the standard tuition because of the excessive cost of textbooks.
Please evaluate for Life Experience
 
Transcripts Attached
 
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Transcripts will be forwarded via e-mail
 
Transcripts will be forwarded via U.S. Mail