Project Graduate Learner Profile

What IF... It were this easy to get started?

Last Name: First Name: MI:

Name as EKU student (if different):

Street Address:

City:

State:

Zip Code:

Preferred Phone Number:

Secondary Phone (optional):

Email Address:

Date of Birth:

Last 4 Digits of SS#:

Please approximate if you do not know the specifics.

First term of attendance:

Last term of attendance:

Number of hours completed:

Cumulative GPA:

Major at time of last attendance:

List any other institutions you have attended since leaving EKU.

What is your primary motivation for completing your bachelor's degree?

What is your biggest concern about returning to college?

Highest degree you aspire to achieve:

Bachelors Masters Professional Ph.D. Unsure

I am comfortable using: (check all which apply)

Internet Email MS Word Excel Access Blackboard

Other (please list)

Language proficiencies (list):

Veteran Status: Yes No

Does your employer offer tuition assistance? Yes No Don't Know

How soon would you want to begin classes?

I am interested in: (Check all that apply)

What institutions (universities, private or community colleges) are near your current residence?

I would like additional information about the following EKU campus and community resources: (Check all which apply)

Career Services	Scholarships	Federal Financial Aid (FAFSA)
Student Technology	Disability Services	Campus Employment
Transferring Courses	Campus Housing	Adult Student Organizations
Area Child Care	Library Services	Co-operative Education