Undergraduate Application for On Campus Admissions Southwestern Assemblies of God University



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Undergraduate Application for On Campus Admissions

Southwestern Assemblies of God University





Please Note: All applicants should send a $35 non-refundable application fee with this application.
I understand and accept the above refund policy. Signature (use last 4 digits of Social Security # if electronic):      

General Information Anticipated Enrollment:  Fall  Spring  Summer Year      



Social Security Number      

Enrollment Status: Never attended college Transfer from another college Previous SAGU student from      to      

Attendance Type: On-Campus Dorm Resident On-Campus Commuter The LEAD Program School of Ministry – SOM (online)

Engage in Missions (online) Dual Credit (online) SOM Site: ____________________



Last Name

     


First Name

     


Middle Name

     


Maiden

     


Preferred Name

     


Current Address

     


City/State/Zip

     


County

     


Preferred Phone (     )      

Type Home Cell Office



Preferred E-Mail Address

     


Personal Information

Age

     


Gender

     


Date of Birth

     


Are you a veteran?

Yes No


If so, are you receiving any VA benefits?

Yes No Type      



Ethnic Group: African-American American Indian/Alaskan Native Asian Caucasian/White Hispanic/Latino

(Select all that apply) International Student/Nonresident Alien Native Hawaiian/Pacific Islander Other      



Are you a U.S. Citizen?

Yes No


If not, do you have a green card? Yes No

If no, what is your visa status?       Country of Citizenship?      



Marital Status: Single Married Separated (date      /     /      ) Divorced (date      /     /      )
Please list the name and age of all of your children under age 18:

     


Emergency Information

Last Name

     


First Name

     


Relationship

     


Phone

     


E-Mail Address

     


Current Address

     


City/State/Zip

     


Last Name

     


First Name

     


Relationship

     


Phone

     


E-Mail Address

     


Current Address

     


City/State/Zip

     


Educational Background

Last High School Attended

     


High School City

     


High School State

     


Type of Diploma Month and year of High School graduation or GED

H.S. Grad GED      



High School GPA

     


List each college/university you have attended. An official transcript from each institution must be sent from the institution directly to the SAGU Admissions Office before acceptance.
School City, State Dates of Attendance GPA Degree Earned

                             

                             

                             

Have you been on academic or disciplinary suspension from any college? (If yes, please explain briefly below.)

Yes No
     


ACT Score

Composite       English       Math       Reading       Science       Date      



SAT Score

Combined       Reading       Math       Writing       Date      



Educational Goals (Select Field of Study)

Bachelor (4-year) Associate (2-year) Non-Degree Seeking

College of Music and Communication Arts

College of Bible and Church Ministries

College of Business and Education

Church Ministries

Bible and Theology***

Biblical Studies

Children & Family Ministries

Church Leadership***

Ministry Track***

LEAD Track

LEAD/MOL Track

Church Planting & Revitalization

Counseling Ministries

Intercultural Studies

Media Ministries*

Music Ministries*

Pastoral Leadership

Theological Studies

Youth & Student Ministries




Counseling/Psychology

Counseling (Pre-Professional)

Counseling (Pre-Professional) with a Minor

Human Services***

Counseling***

Criminal Justice***

Psychology***

Social Work***

Psychology (Pre-Professional)

Psychology (Pre-Professional) with a Minor


Criminal Justice

Criminal Justice


Social Work

Social Work (Pre-Professional)*

Social Work (Pre-Professional) with a Minor*
Associate Degrees:

Bible


Intercultural Studies

Psychology



Business

Accounting*

General Business

Human Resource Management

Management

Marketing

Sports Management*
Education

Education (Non-Certification)

Elementary Education

Middle & Secondary Education

Eng. Language Arts/Reading

Math


Social Studies/History

Music Education (All Levels)*

Instrumental*

Piano*


Vocal*

Physical Education (EC-12)*

Theatre Education (EC-12)*


History

Ancient Studies

History
Interdisciplinary Studies

Interdisciplinary Studies***


Math

Mathematics


Associate Degrees:

Business Administration

Early Childhood Education

Education

General Studies

Social Studies



Communication Arts

Communication Studies*

Digital Media Arts*

Theatre*
English

English
Music Performance

Instrumental*

Piano*

Vocal*
Associate Degrees:



English

Media*


Music*

* On Campus Only

** Online Only

*** Maximum Transfer



Student Profile

SAGU’s admission policy requires all students to have a born-again salvation experience as indicated in John 3:3 and other scriptures. SAGU is open to students of Christian faith and the University teaches a biblical Christian worldview. A copy of the Statement of Fundamental Truths of the Assemblies of God is available upon request.

The University also maintains an abstinence policy regarding tobacco, alcohol, any illegal drugs or mind-altering substances, as well as inappropriate sexual conduct of any nature.


Last Name

     


First Name

     


Middle Name

     


Church Attending

     


Church City

     


Church State

     


Pastor’s Name

     


If Assemblies of God, what District?

     


Denomination

     


If you hold credentials, indicate which:

Ordained Licensed Certified Minister


Denomination or Fellowship:      



Have you accepted Jesus Christ as your personal Savior and Lord? (Romans 10:9-13; John 3:16; and Acts 2:38) Yes No Date of Salvation:      

Do you strive to live a Christian lifestyle? Yes No

Have you been baptized in water? (Mark 16:16) Yes No

Have you received the Baptism in the Holy Spirit with the evidence of speaking in tongues? (Acts 2:4) Yes No





In the last 3 years, have you:

Used tobacco/nicotine in any form including electronic Cigarettes? Yes No

Consumed alcohol in any form? Yes No

Used illegal drugs or mind-altering substances including marijuana? Yes No

Intentionally viewed pornography/sexually explicit material? Yes No

Been sexually active outside of heterosexual marriage? Yes No

Been involved in a same sex relationship or participated in transgenderism? Yes No

If yes to any of the above. please explain and indicate date of discontinuance?      

     

Have you ever been convicted of a felony? Yes No If yes, please attach a written/typed explanation and provide dates.

Are you currently on Parole? Yes No Are you currently on Probation? Yes No

If yes, provide Parole/Probation Officer’s name and number      





Are you a child or grandchild of a SAGU alumnus? Yes No

If yes, list names and dates of attendance if known.

Name:       Date of attendance      

Name:       Date of attendance      



Short Essay Question

Using 200-500 words, please describe and discuss in a well-written essay how your personal salvation and faith in Christ is lived out in your daily life and your reasons for choosing SAGU.

This essay and information below are considered carefully for admissions and scholarship awarding decisions. (If more space is needed please attach a separate sheet.)

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Outline your church and ministry involvement/activities, past and present.



  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

Outline your school and community involvement/activities, past and present.

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

Outline your future educational and career goals.

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

  • _________________________________________________________________________________________________________________________________

SIGNATURE
I certify that all information in this application is complete and accurate. I understand that acceptance to Southwestern Assemblies of God University is subject to verification of final records from all institutions I have attended. If accepted, I agree to abide by the policies and high moral standards of Southwestern Assemblies of God University, and to be responsible for payment of all educational costs.

Date       Signature (use last 4 digits of SSN if electronic)      

This completed and signed application can be submitted via:
Mail: Southwestern Assemblies of God University, Admissions Office, 1200 Sycamore Street, Waxahachie, TX 75165

Fax: 972-923-8133 Email: Admissions@sagu.edu

Southwestern Assemblies of God University
is in compliance with all applicable regulations pertaining to non-discrimination on the basis of sex, race, color, national or ethnic origin, age, and disability in its recruitment, admission, education, financial aid, and employment policies and programs. Christian Character Reference

Applicant Instructions and Information Anticipated Enrollment:  Fall  Spring  Summer Year      



Please complete this section and sign the statement below if you wish to waive your rights as stated. Your pastor, former pastor, youth pastor, or church lay-leader
(elder, deacon, or board member) should complete the Recommendation section. (The individual may not be a relative.)




Student’s Last Name

     


Student’s First Name

     


Middle Name

     


Student’s Current Address

     


City/State/Zip

     


According to PL 39-380, the Family rights and Privacy Act of 1974, the information contained in this reference questionnaire must be shared with the student upon request. However, the applicant may, at his/her discretion, voluntarily waive the right of access to the information by signing the following statement.

Waiver of Rights: I hereby waive my right of access to all information contained in this reference questionnaire with the understanding that it will be used only for the purpose of evaluating my application for admission to Southwestern.



Signature (use last 4 digits of SSN if electronic)

     


Date

     


Recommendation

The person named above on this reference form has applied for admission to Southwestern Assemblies of God University and has given your name as a reference. Please complete the following reference form to the best of your knowledge and return to: SAGU, Admissions Office, 1200 Sycamore, Waxahachie, Texas, 75165.

How long have you known the applicant?      

To what extent have you known the applicant? Personal relationship Somewhat closely Indirectly Distantly

To your knowledge, in the past 3 years has he/she: Used drugs illegally? Yes No Used tobacco? Yes No

Used alcohol? Yes No Struggled with pornography? Yes No

Struggled with sexual promiscuity? Yes No Struggled with homosexuality? Yes No

To your knowledge, has the applicant ever been divorced? Yes No Remarried? Yes No

Do you know of anything, which might hinder the applicant from making satisfactory progress as a student? (If so, please comment on separate page.) Please check the following: Excellent Good Fair Poor Not Known

Moral character

Emotional stability

Leadership

Influence on others

Concern for others

Attitude toward authority

Church involvement

Readiness for college

(If you check fair or below on any of these, please give additional explanation on separate page.)

For admission to Southwestern Assemblies of God University, this student is recommended:
With enthusiasm Strongly With Reservation Not Recommended


Please Print Your Name:      

Signature (use last 4 digits of SSN if electronic)

     


Position

     


Date

     


Church

     


Denomination

     


Phone

     


Address

     


City/State/Zip

     


Thank you for your assistance. This completed and signed application can be submitted via:
Mail: Southwestern Assemblies of God University, Admissions Office, 1200 Sycamore Street, Waxahachie, TX 75165
Fax: 972-923-8133 Email: Admissions@sagu.edu Academic Information

  • Provide an official high school transcript showing the date of graduation and a minimum GPA of 2.0* from an accredited public or private high school, home school, or proof of high school equivalency (GED). The high school transcript must include the appropriate college preparatory classes.

    Note: Students transferring to SAGU with at least 21 college hours of general education credit will not be required to submit a high school transcript.

  • Provide scores from the American College Test (ACT) or Scholastic Aptitude Test (SAT) taken within the last 5 years. The minimum score required for the ACT is a composite of 19*, or a combined SAT score of 1350* (Critical Reading + Math + Writing).

    Note: Students transferring to SAGU with at least 21 college hours of general education credit will not be required to submit an ACT/SAT score.

  • Official transcripts from each college attended must be sent directly from that college to:
    SAGU Admissions Office, 1200 Sycamore, Waxahachie, Texas 75165.

* Students who do not meet the minimum academic admissions requirements may be considered for admission on a case-by-case basis as determined by the Admissions Committee. Contact your Admissions Counselor (On-campus Counselors | Online Admissions Counselors) for more information.

All materials submitted during the admissions process become property of SAGU and will not be returned.Medical History

Applicant Instructions Anticipated Enrollment:  Fall  Spring  Summer Year      

Last Name

     


First Name

     


Middle or Maiden

     


Preferred Name

     


Current Address

     


City/State/Zip

     


Birth Date

     


Last 4 digits of Social Security #

     


College Classification

Freshman Sophomore Junior Senior



Marital Status

Married Single Divorced



Do you have any history of the following illnesses?

Asthma Epilepsy Poliomyelitis Thyroid Chickenpox Malaria

Rheumatic Fever Tuberculosis Diabetes Measles Scarlet Fever Typhoid Fever

Diptheria Mumps Smallpox Whooping Cough



Do you have any allergies?

Food? Yes No Please List:      

Medicine? Yes No Please List:      

Other? Yes No Please List:      

Have you ever been treated for: Emotional instability Psychological problems Trauma Mental illness

List any other illnesses:      

List any major health problems:      

List major surgeries/procedures and give the approximate dates:      



     

Do you have a physical handicap? Yes No If so, please explain:      

Do you consider your general health good? Yes No If not, please give details      

     

Are you taking any prescription or over-the-counter medications regularly? Yes No

If so, please list names, dosages, and frequency:      


Family Health Information




Name

Age

Occupation

Age at death

Cause of death

Father

     

     

     

     

     

Mother

     

     

     

     

     

Siblings

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

Required Immunizations: All students under 30 years of age taking on campus classes are required to have the following immunizations.


Official shot records are required.


Meningitis (within last 5 years) Completed Yes No Date of last injection:      

Mumps/Measles/Rubella Completed Yes No Date of first injection:       Date of last injection:      

(2 Dates Required: MMR Booster required for all students.)

Polio (if under age 19) Completed Yes No Date of last injection:      

(Poliomyelitis: Minimum of three doses (oral) with at least one dose since 4th birthday.)

TB Skin Test (within last year) Completed Yes No Date of test:       Results:      



Dorm Reservation

Applicant Instructions and Information



A student cannot be placed and this request cannot be processed until you have applied and been accepted as a student to Southwestern Assemblies of God University. Please complete this form and return it along with your $150 room deposit to:

SAGU Admissions, 1200 Sycamore, Waxahachie, Texas, 75165.


* $50 is non-refundable in all cases. $100 of this deposit will be credited to your student account after dorm move-in and late registration. If you decide not to attend, we must receive written notification before July 15 (fall semester deadline) or December 10 (spring semester deadline) in order to receive a $100 reimbursement. If we are not contacted by these deadlines, any type of reimbursement will be forfeited.
I understand and accept the above refund policy. Signature (use last 4 digits of SSN if electronic):      

Student Status: Freshman Transfer

Reservation for: Fall Spring Year      

Last Name

     


First Name

     


Middle Name

     


Last 4 digits of Social Security #

     


Birth Date

     


Phone

     


Current Address

     


City/State/Zip

     


Residence Hall Request (Mark 3 choices by priority using numbers 1, 2 and 3)

Men     Guynes     Savell     Teeter     Bridges     Collins (Oaks School of Leadership Only)

Women     Kendrick     Guynes     Savell     Teeter     Bridges     Collins (Oaks School of Leadership Only)

Personal Information

The following information will assist the residence hall staff in placing you with a compatible roommate, however, nothing is guaranteed.

Age

    


Intended Major and Specialization

     


Do you study in your room: Frequently Infrequently

Do you prefer to go to bed: Early Late Very Late

Are you an early riser in the morning? Yes No

Would you consider yourself: Tidy Not So Tidy

Do you like to study: With Music/TV or Without Music/TV

What type of music do you prefer?      

What are your hobbies and personal activities?

     


What sports interests do you have, and are you involved in on-campus athletic programs?

     


Do you have any special medical/health concerns that we need to take into consideration? Yes No

If yes, please explain:      



If you have a roommate preference, please put his/her name here:

(Roommate preference will be based on availability and preferred roommate’s acceptance status at time of placement. Your preferred roommate must also request you on his/her form.)



     




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