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* Work Phone* Best Time to CallPlease 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* City* State/Province Country*Please select... Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos ( Keeling ) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d ' Ivoire Croatia ( Hrvatska ) Cuba Cyprus Czech Republic Congo ( DRC ) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands ( Islas Malvinas ) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong SAR Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Samoa San Marino São Tomé and Prìncipe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam Virgin Islands ( British ) Virgin Islands Wallis and Futuna Yemen Zambia Zimbabwe Zip or Postal Code Gender Please select... Female Male How did you hear about Concordia? Please select... 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 Master of Arts in Psychology: Community Psychology Master of Arts in Teaching (MAT) Master of Arts in Teaching English to Speakers of Other Languages Master of Business Administration Master of Education Master of Education in Special Education Master of Education in Advanced Special Ed Anticipated Start Term* Please select... Spring 2016 Summer 2016 Fall 2016 Spring 2017 Summer 2017 Fall 2017 Comments/Questions Questions? Problems with this form? Contact the Office of Admission at 1-800-321-9371 or .