If you would like to be considered for admission to Brixton
University, please complete the form below. All fields containing a
* must be filled out. |
CONTACT INFORMATION |
| TITLE: |
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| * LAST NAME: |
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| * FIRST NAME: |
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| MIDDLE INITIAL: |
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EMAIL: |
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| * RE-ENTER EMAIL: |
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| * STREET
ADDRESS |
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| * CITY: |
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| STATE: |
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| * ZIP
CODE: |
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| COUNTRY: |
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| PHONE: |
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| HOW DID YOU FIND US? |
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| IF OTHER PLEASE SPECIFY: |
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Brixton University Degree Program / First
DegreeIf requesting multiple degrees (i.e. Bachelors/Masters,
or Masters/Doctoral), please use the First
Degree dropdown for your first degree and First Requested Major, please use the Second Degree dropdown for the second degree
and the Second Requested Major.
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| FIRST DEGREE:
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| FIRST MAJOR:
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| If your requested major is not listed, please list here. |
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Brixton University Degree Program / Second
Degree |
| SECOND
DEGREE: |
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| SECOND MAJOR:
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| If your requested major is not listed, please list here. |
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Education |
List all institutions attended, with dates and degrees
earned, if any. If you have never attended a college or university,
please click here. |
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| List any special educational experiences you have had, such
as independent study projects, work as a tutor, corporate training, study
abroad, etc., and any school, community, sports, and religious activities
in which you have participated. Include any special recognition you have
recieved for these activities. |
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Military Experience |
| Please list any past or current military experience and
training. |
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Professional and
Business Experience |
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Please cut and paste your resume into the text area
below. Please note, you will lose all formatting, so please separate
sections with spacing. |
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Please Read Before Submitting Your Application
Required Acknowledgement:
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Select "I accept" from the following box to
certify that you have read and accepted the above statement and
that all information contained in this application is true and
correct. |
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