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Dual Enrollment Application

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Personal Information

First Name *

Last Name *

Birthdate *

Birthdate *

Email Address *

Sex *

Sex *

Female

Male

Social Security Number *

Mailing Address *

Mailing Address *

Country

Street

City

Region

Postal Code

Phone Number

Mobile Phone Number *

May we send you updates via text message?

May we send you updates via text message?

Yes

No

Primary Citizenship *

Secondary Citizenship *

I am a legal permanent resident of the U.S.

Are you Hispanic or Latino?

Are you Hispanic or Latino?

Yes

No

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific

White

Please use the space below to provide information for a family members that may be contacted.

Parent/Guardian First Name:

Parent/Guardian Last Name:

Parent/Guardian Phone Number:

Parent/Guardian Email:

Academic Information

Please enter information for the high school you currently attend. To find your school, begin typing the name or location in the text box, and select your school from the suggested results.

School *

CEEB (HIDDEN)

Level of Study (HIDDEN)

Degree (HIDDEN)

Expected Graduation Date

Expected Graduation Date

Self-Reported GPA

Start Date

Course Information

Please indicate the courses in which you are interested in taking dual enrollment courses. You may select courses or enter the name of the courses you wish to take.

Course Areas (select up to 3)

Course Areas (select up to 3)

Agronomy

College Algebra

Composition 1

Composition 2

Contemporary Economics

Digital Photography

Earth Science

General Biology

Intro to Agriculture

Intro to Animal Science

Intro to Business

Intro to College Writing and Thinking

Intro to Plant Science

Mathematics for the Liberal Arts

Medical Terminology

Music in the Western World

Social Problems

Specific Course(s)

Round

Round Always Create

Submitted

Create PIN

Student Type

Website

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Contact

Warner University
13895 Highway 27
Lake Wales, Florida 33859

Office Hours: 9am-4pm
Local: (863) 638-1426
Toll Free: (800) 309-9563

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