COLUMBUS UNIVERSITY
“The Established Name in Distance Education”
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  Application to Columbus University

Please complete the form below to receive an Admissions Package.

Fields denoted by a (*) must be completed for application to be submitted. 


  *First Name  
  Middle Name
 *Last Name
 *Street Address
 *Street Address 2
 *City
 *State or Province
 Zip/Postal Code
*Country
  Home Phone #
  Work Phone #
  Cell Phone #
  How did you hear of Columbus University?
*Email Address
  Marital Status
  Date of Birth
  Sex
 *Occupation
  Number of years in work force
  Current level of education
*Please send me information on the Degree Program
  *Major:
Questions/Comments:
 

 
P.O. Box 2491
Daphne, AL 36526
Phone: (888) 572-0255 or (251) 621-0063
Facsimile: (888) 572-0256 or (251) 621-0064
Email: admissions@ColumbusU.com
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