Tell us about yourself First Name * Last Name * Preferred First Name Email Address * Preferred Phone Type * Please select... Home Cell Work Home Phone * Cell Phone * Best Time to Call Please select... 8:00 am - 10:00 am 10:00 am - 12:00 pm 12:00 pm - 2:00 pm 2:00 pm - 4:00 pm 4:00 pm - 6:00 pm After 6:00 pm Birthdate Address * Include PO Box or apartment number City * State/Province * Please select... ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FED STATES OF MICRONESIA FLORIDA GEORGIA GUAM GU HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA N. MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING Zip or Postal Code * Gender Please select... Female Male How did you hear about Concordia? Campus Visit College Fair College Representative Visited My School CU-Portland Website Friend or Teacher Another Website Church Athletics Concordia Faculty/Staff Newspaper Ad Radio Ad I will enter Concordia as a: Please select... New Freshman New Transfer Graduate Transfers have 12 or more college semester credits or 18 or more quarter college credits. Graduate students must hold at least a four-year degree from an accredited institution. Anticipated Major Please select... Accounting Biology BS Social Work Business Administration Chemistry Christian Education Communications Early Childhood Education Education K-8th Grade Education Middle-High School English Exercise & Sports Science Healthcare Administration History History Homeland Security Humanities Interdisciplinary Studies Marketing Molecular Biology Music Nursing Pre-Athletic Training Pre-Medical Studies Pre-Occupational Therapy Pre-Physical Therapy Pre-Physician's Assistant Pre-Seminary Studies Psychology Social Work Sports Management Teaching (Elementary) Teaching (Secondary) Theology Theology PCW Anticipated Major Please select... Master of Arts in International Development and Service Doctor of Education Master of Arts in Psychology: Community Psychology Master of Arts in Teaching (MAT) Master of Arts in Teaching English as a Second Language Master of Business Admininstration Master of Education Master of Education in Special Education Anticipated Start Term Please select... Summer 2014 Fall 2014 Spring 2015 Summer 2015 Fall 2015 Spring 2016 Comments/Questions Questions? Problems with this form? Contact the Office of Admission at 1-800-321-9371 or .