Student Name Student ID # (if known) Address City

[PDF]Student Name Student ID # (if known) Address City...

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Student Name (Please Print)





Student ID # (if known) Address City State Zip Code Home Phone Work Phone Cell Phone

Social Security Number XXX-XX-

(Last 4 #’s)

• Southern Wesleyan University will award a 10% scholarship to employees of Scholarship America Affiliate Organizations who enroll in a SWU online degree program. • The 10% scholarship will be applied proportionately to each course of the entire program. The scholarship will be applied only toward tuition. • Students receiving tuition benefits from outside sources, including VA benefits, military benefits, state and federal scholarships & grants, and tuition assistance programs, may still qualify for scholarship assistance up to, but not to exceed, 100% of tuition expenses. • Student is required to meet all admission standards for the desired degree program. • Student must adhere to policies listed in the Undergraduate or Graduate Bulletin that include policies related to class attendance, academic standing, and other requirements.

Contact for Authorization: Student Signature

Affiliated Company Authorization

Phone Email

PLEASE RETURN BY MAIL, FAX, OR EMAIL: Southern Wesleyan University Office of Student Accounts 907 Wesleyan Drive Central, SC 29630

[email protected] Fax : 864.644.5970