NetDegree

4. When are you planning on starting your education at Kaplan University? *
   Immediately Within the next 3 months Within the next 6 months Within the next year
5. Which area of study are you interested in? *
   Please choose... Arts and Sciences Business Criminal Justice Legal Studies Information Systems and Technology Health Sciences Nursing
7. First Name: *
8. Last Name: *
9. Email Address: *
10. Evening Phone: *
11. Daytime Phone: *
12. Address Line 2:
13. Zip Code: *
14. City: *
15. Address Line 1: *
16. State: *
    Please choose a state AL - Alabama AK - Alaska AS - American Samoa AZ - Arizona AR - Arkansas CA - California CO - Colorado CT - Connecticut DE - Delaware DC - District of Columbia FL - Florida GA - Georgia GU - Guam HI - Hawaii ID - Idaho IL - Illinois IN - Indiana IA - Iowa KS - Kansas KY - Kentucky LA - Louisiana ME - Maine MD - Maryland MA - Massachusetts MI - Michigan MN - Minnesota MS - Mississippi MO - Missouri MT - Montana NE - Nebraska NV - Nevada NH - New Hampshire NJ - New Jersey NM - New Mexico NY - New York NC - North Carolina ND - North Dakota OH - Ohio OK - Oklahoma OR - Oregon PW - Palau PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VT - Vermont VI - Virgin Islands VA - Virginia WA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming FM - Federated States of Micronesia MH - Marshall Islands MP - Northern Mariana Islands - Outside of the U.S.A. AE - Africa AA - Americas (Except Canada) AE - Canada AE - Europe AE - Middle East AP - Pacific
17. Are you a U.S. citizen, national, or permanent resident? *
    Yes No
18. Country: *
    Please choose a country United States American Samoa Guam Micronesia, Federated States of Northern Mariana Islands Puerto Rico Virgin Islands (U.S.) Albania Algeria 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 Darussalam Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Espana Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (South) Korea, Republic of Kuwait Kyrgyzstan Latvia Lebanon Lesotho Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Ireland Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russia Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa (Independent) San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka St. Helena St. Pierre and Miquelon Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Wales Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe
19. What is the highest academic credential you possess? *
    Still in high school GED High school diploma Some college (fewer than two years) Associate's degree Bachelor's degree Post-graduate study Master's degree Doctoral degree None of the above
20. Will you have access to a computer to take your courses? *
    Yes No
21. Are you or your spouse Active or a Reservist in the U.S. Military? *
    Yes No
22. Are you planning on using Military benefits to fund your education? *
    Yes No I don't know
23. By submitting this Student Information form, I acknowledge that Kaplan University will contact me via email and telephone. *

* Required field