Chong Shin University in U.S.A.School of Theology / School of Church Music
APPLICATION FOR ADMISSION
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Ethnic & Racial Survey (Optional) To determine accurately institutional compliance with the Federal Rights Act of 1964, �e Department of Health,Education and Welfare requires to have each enrolling student provide the following data.Please Check Only One:
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Spring 20_ _ Summer 20_ _ Fall 20_ _ Winter 20_ _
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English is the language I speak most often
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Are you a U.S. Citizen?
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I expect to work hourseach week this semester
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Chong Shin University in U.S.A.School of Theology / School of Church Music
�is is to certify that all statements indicated onthese pages are true. I understand that falsificationof any statement may result in cancellation of myregistration.
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1. Permanent Resident 2. Student F-1 Visa
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3. Visitor B1/B2 4. Refuges 5. Processed 1551 for Perm. Res.
6. Temporary Res./Amnesty
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