Degree Program Enrollment Application     B.A. in Government B.A. in Business Administration Associate of Arts   Title Mr. Ms. Miss Mrs. First Name: (required) Middle Name: Last Name: (required) Email: (required) Home Address: Address (cont.): City: State/Province: Country: Zip/Postal Code: Phone: Date of Birth (mm) (dd) (yyyy) Citizenship U.S. CitizenU.S. Permanent Resident Other Have you earned a high school diploma? YesNo   List any high schools you attended and the date you earned your high school diploma:   List any college(s) you have attended and degrees earned:   Please list the names of two references. At least one must be someone who can affirm your academic abilities:   Please tell us how you heard about Yorktownuniversity.com: List any questions you have regarding Yorktownuniversity.com:

Yorktown University 4340 East Kentucky Avenue, Suite 457 Denver, CO 80246 Phone: 877-757-0059 Copyright © 2000-2008 Yorktown University, Inc. All Rights Reserved.