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ESSENTIAL INFORMATION

Preferred Name:

{firstName} {lastName}

Email Address:

{emailId}

MY PROGRAM

Highest Degree Earned in United States?:

{engProficiency}

Highest Degree taught in English?:

{intlDegreeEng}

Taken English Proficency Exam?:

{intlExamEng}

Transcripts been reviewed by an approved evaluator?:

{intlTransReview}

Degree Level to Pursue:

{acadCareerDesc}

Area of Study:

{custom-areadOfStudy}

Courses:

{custom-courseId}

Program:

{acadProgDesc}

Specialization:

{acadPlanDesc}

Concentration:

{subPlanDesc}

Learning Format:

{custom-sessionCode}

Start Date:

{sessionStartDt}

ABOUT ME

Country:

{custom-country}

State/Province:

{custom-state}

Street Address:

{address1}

Apartment, Suite, etc:

{address2}

City:

{city}

Zip/Postal Code:

{postal}

Phone Number:

{phone}

Have you served, or are you a spouse or dependent of someone who served in the U.S. military?

{militaryMember}

What is your current military status?:

{militaryStatus}

What is your military branch?:

{militaryBranch}

Do you currently live in base housing or receive a monthly military housing stipend?:

{militaryBase}

Do you intend to use education benefits earned through military service?:

{militaryBenefits}

Birthdate:

**/**/****

Country of Citizenship:

{custom-citizenCountry}

Social Security:

***-**-****

Legal Name:

{legalFirstName} {legalMiddleName} {legalLastName}

How do you identify your gender?:

{custom-gender}

What are your pronouns?:

{custom-pronoun}

What is your sex?:

{sex}

Are you Hispanic/Latino/Latinx?:

{ethnicGrpCd}

Select any of the following that would describe yourself?:

{custom-ethnicity}

MY EXPERIENCES

SCHOOL

School Name:

{schoolName}

Transcript Request Status

{transcriptStatus}

Transcript Submitted

{TranscriptSubmit}

When did you receive your GED?:

{gedDegreeDate}

Degree Name:

{custom-descr}

When did you receive your diploma?:

{hsDegreeDate}

Date Attended:

{fromDate} - {toDate}

Did you graduate or will you graduate before you begin your program at Capella?:

{degreeStatus}

Graduation Date:

{degreeDate}

Grade Point Average(GPA):

{gpa}

EMPLOYER

Employment:

{employmentDescr}

Country:

{custom-country}

State:

{custom-state}

When did you start working here?:

{startDate}

When did you become unemployed?

{unemployedDate}

What’s your job title?:

{titleLong}

Name on RN License:

{cuLicenseName}

RN License Number:

{licenseNbr}

State:

{custom-cuLicenseState}

Expiration Date:

{expirationDate}

Applications

Need to update your application?

ESSENTIAL INFORMATION

Preferred Name:

Email Address:

MY PROGRAM

Highest Degree Earned in United States?:

Highest Degree taught in English?:

Taken English Proficency Exam?:

Transcripts been reviewed by an approved evaluator?:

Degree Level to Pursue:

Area of Study:

Courses:

Program: Edit

Specialization:

Concentration:

Learning Format:

Start Date: Edit

ABOUT ME

Country:

State/Province:

Street Address:

Apartment, Suite, etc:

City:

Zip/Postal Code:

Phone Number:

Have you served, or are you a spouse or dependent of someone who served in the U.S. military?

What is your current military status?:

What is your military branch?:

Do you currently live in base housing or receive a monthly military housing stipend?:

Do you intend to use education benefits earned through military service?:

Birthdate:

Country of Citizenship:

Social Security:

Legal Name:

How do you identify your gender?:

What are your pronouns?:

What is your sex?:

Are you Hispanic/Latino/Latinx?:

Select any of the following that would describe yourself?:

MY EXPERIENCES

SCHOOL

School Name:

Transcript Request Status

Transcript Submitted

When did you receive your GED?:

Degree Name:

When did you receive your diploma?​:

Date Attended:

Did you graduate or will you graduate before you begin your program at Capella?:

Graduation Date:

Grade Point Average(GPA):

EMPLOYER

Employment:

Country:

State:

When did you start working here?:

When did you become unemployed?

What’s your job title?:

Name on RN License:

RN License Number:

State:

Expiration Date:

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Program:

Start Date:

When did you receive your diploma?: