Certificate Program Application

Welcome to the St. John's University Certificate Program Application. Please read carefully and complete all applicable questions on this form. Required fields are denoted by double asterisks (**) and must be completed before the application can be submitted.

Before beginning, please note that if you close the application before clicking the submit button, you will need to re-enter the information again as this application does not have a "save" option.

College/University Name **

College/University Address **

Country

Street

City

Region

Postal Code

Degree Earned **

Attendance Start Date **

Attendance End Date **

How did you learn about St. John's University and the School of Risk Management, Insurance and Actuarial Science?**

Privacy Notice

I acknowledge it is my responsibility to review the University’s data privacy notice found at www.stjohns.edu/compliance.

Compliance Date Acknowledgment **

Voluntary Consent

St. John's University seeks to provide students with important information in a timely fashion and utilizes electronic student portals and email to communicate and share information on financial aid funds for each award year and how and when funds will be disbursed, federal student loan and grant information, student account and billing information. By providing your voluntary consent, you are opting to conduct electronic transactions with the University that may occur at any time during your academic career. You may withdraw your consent to electronically conduct business at any time by opting out of email communications, signing out of the University Information System and for financial aid purposes by contacting the Office of Student Financial Services in writing. The University reserves the right to provide information in paper format. Student Consumer Information is always available at www.stjohns.edu/Consumer.

I acknowledge that I have read this consent statement and I:**

Signature

By signing below and clicking submit, you agree to the following:

I am formally applying to participate in the St. John's Certificate Program.
The information submitted in this application is factually true and honestly presented.
I certify that all of the information given on this application is complete and accurate. I take full responsibility for notifying St. John's University of any changes in the above information.

In place of your signature, please type your full legal name:**

Date

Slate Branding

Certificate Program Application