On-Line Application

* = Required

     *First Name 
      *Last Name 
  Middle Initial 

            *Sex Male Female

  *Date of birth 
  Place of birth 

Social Security # 

   *Home Address 
     Apt.#/Suite 
           *City 
 *State/Province 
*Zip/Postal code 
        *Country 

      Work Phone 
     *Home Phone 
             FAX 
         *E-mail 	 Your application evaluation results will be e-mailed 
					  to this account. Please provide an e-mail address 
					  you check often.	

   Do you have access to an IBM or IBM Compatible Computer? 
		      Yes No

   Is your PC equipped with a CD-ROM Drive? 
		      Yes No

   Do you have internet access?		
	At Work?      Yes No	

	At Home?      Yes No

    Employment History:

  Occupation/Job Title 
   Years of Experience 
              Employer 

  Occupation/Job Title 
   Years of Experience 
              Employer 

  Occupation/Job Title 
   Years of Experience 
              Employer 

Educational Background:      

	   High School 
	          City 
  	         State 
 	       Country 

    College/University 
	Dates Attended	 From          To
		          
	          City 
  	         State 
 	       Country 
		Degree NoneAssociate's DegreeBachelor's DegreeMaster's DegreeDoctorate Degree
 	  	 Major  None 
Number of Credits Completed  SemesterQtr.
Have you completed this degree? Yes No	

    College/University 
	Dates Attended	 From          To 	      
		          
	          City 
  	         State 
 	       Country 
		Degree NoneAssociate's DegreeBachelor's DegreeMaster's DegreeDoctorate Degree
		 Major  None 
Number of Credits Completed  SemesterQtr.
Have you completed this degree? Yes No

    College/University 
	Dates Attended	 From          To 	      
		          
	          City 
  	         State 
 	       Country 
		Degree NoneAssociate's DegreeBachelor's DegreeMaster's DegreeDoctorate Degree
		 Major  None 
Number of Credits Completed  SemesterQtr.
Have you completed this degree? Yes No	

        Specialized Training:

     Name of School or
     Training Facility 
              Location 
	Dates Attended	 From          To 		
		          
       Course of Study
	      or Major 
                       Certificate  
		       Diploma 
       Number of Hours
	of Instruction 

     Name of School or
     Training Facility 
              Location 
	Dates Attended	 From          To
                          
       Course of Study
	      or Major 
                       Certificate  
		       Diploma 
       Number of Hours
	of Instruction 

     Name of School or
     Training Facility     		       
              Location 
	Dates Attended	 From          To
                          
       Course of Study
              or Major 
                       Certificate  
		       Diploma 
       Number of Hours
        of Instruction 

Please Check Program of Interest:

 Bachelor's Degree in Management - $4,000
 Bachelor's Degree in Business Administration - $4,000
 Master of Business Administration - $4,000
 Bachelor's and Master's Degree Program - $6,400
	Elective 

Tuition and Registration Fees Payment Options:

Option A: One will obtain a 10% discount from
        the total tuition and registration fee by making
        one payment within 15 days of the issuance of
        the Preliminary Letter of Acceptance.

Option B: Pay-as-you-go. FTU will work individually
        with you to develop a program that meets your
        needs.

Scholarships:

Are you interested in receiving a scholarship?
	Yes       No     

Please send the following documents by fax, mail or email attachment.  Copies will suffice for evaluation purposes:
Copies of your previous college transcripts (if any)
              Printable Transcript Request Form  
                (requires Adobe Acrobat Reader)          
Copies of your CLEP, ACT-PEP, DANTES (if any)
Copies of your professional certificates, licenses and corporate training programs (if any)

These items should be mailed, faxed or emailed to:

            Frederick Taylor University
            346 Rheem Boulevard, Suite #203
            Moraga, CA 94556

            fax: (925) 376-0908
            email: admissions@ftu.edu

UNDERSTANDINGS:

I have read and fully understand the concept of education utilized by
the University.  I understand that within10 business days of receiving
my application, Frederick Taylor University will inform me of the 
status of my application. I understand that there are no interest 
charges on the time of payment plan and no cost for textbooks and 
study materials. I hereby certify that the information provided here 
is accurate.

Applicant's Name: 
        Date: