Impact College 2022-2023 Application
This application contains 12 sections. Questions will include demographic information, personal health information, relationships, church activities, references, etc. Please allow 30-60 minutes to answer all questions to the best of your ability. All questions require an answer. If the question is not applicable, please answer "n/a" or "none" per question guidelines. Please be truthful in your responses. Answers to certain questions of a personal nature may not immediately disqualify an applicant, but may necessitate a more in-depth interview of the applicant prior to making an enrollment decision. A statement/answer found to be false or misleading will be grounds for denying the applicant enrollment to Impact College.  All answers will remain confidential to Impact College Administration.  
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Email *
Last Name *
First Name *
Address (Please include state and zip code) *
Home Phone *
Cell Phone *
Work Phone *
Last 4 of Social Security Number *
Date of Birth *
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Current age today *
Sex
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Please select what program you are applying to: *
Are you a U.S. Citizen? *
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