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Read application carefully before completing. Give all information requested (Name, Address, etc.).  If more space is required, attach extra pages and send via email, fax or mail. There is a $50.00 nonrefundable application processing fee. To pay by check, please also print a copy of the completed form and mail to the address below with your check. For immediate processing, applications should be submitted via the online form below. If you would like to apply via mail, download and complete the appropriate degree or certificate application. American Graduate University 733 North Dodsworth Avenue Covina, California 91724-2499 Toll Free: (877) 351-9060 | Phone: (626) 966-4576 | Fax: (626) 915-1709

Degree Application

Certificate Application

Education Objective (Select One)
Degree:	N/A Master of Acquisition Management Master of Contract Management Master of Leadership and Management Master of Project Management Master of Supply Chain Management MBA – Acquisition & Contract Mgmt MBA – General Management MBA – Project Management MBA – Supply Chain Management
OR
Certificate:	N/A Acquisition and Contracting Business Management Financial Management and Pricing Project/Program Management Supply Chain Management
Concentration (if applicable):	N/A

Personal Information
(*) indicates required field
*Prefix:	Mr. Mrs. Ms. Dr.
*First Name:
*Last Name:
Maiden Name:
Birth Date:	(mm/dd/yyyy)
*Email Address:
*Mailing Address1:
Mailing Address2:
*City:
*State:	-- Choose a State -- Not Applicable AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming Z1 - Armed Forces Americas Z2 - Armed Forces Europe Z3 - Armed Forces Pacific
*Zip Code:
*Country:
*Home Phone:
*Cell/Mobile Phone:
*Home Address1:
Home Address2:
*Home City:
*Home State:	-- Choose a State -- Not Applicable AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania PR - Puerto Rico RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming Z1 - Armed Forces Americas Z2 - Armed Forces Europe Z3 - Armed Forces Pacific
*Home Zip Code:
*Home Country:

* Statement of Goals

Please submit a brief statement of your professional and educational objectives, including your reasons for pursing the degree or certificate program.

Present Employment
Employer:
Division/Branch:
Job Title:
Work Phone:
Office Address1:
Office Address2:
* Job Description:

Professional Experience (List most recent first; omit present employment.)
Employer:	Job Title:	From: mm/dd/yy	To : mm/dd/yy

College or Universities attended (Degree applications must have a Baccalaureate degree from a recognized university.)
University:
City:		State:		Country:
From [mm/dd/yy]:		To [mm/dd/yy]:		Graduated:
Graduation [mm/dd/yy]:		Major:		Degree Earned:
University:
City:		State:		Country:
From [mm/dd/yy]:		To [mm/dd/yy]:		Graduated:
Graduation [mm/dd/yy]:		Major:		Degree Earned:
University:
City:		State:		Country:
From [mm/dd/yy]:		To [mm/dd/yy]:		Graduated:
Graduation [mm/dd/yy]:		Major:		Degree Earned:
University:
City:		State:		Country:
From [mm/dd/yy]:		To [mm/dd/yy]:		Graduated:
Graduation [mm/dd/yy]:		Major:		Degree Earned:
University:
City:		State:		Country:
From [mm/dd/yy]:		To [mm/dd/yy]:		Graduated:
Graduation [mm/dd/yy]:		Major:		Degree Earned:

List applicable courses at the graduate level satisfactorily completed for which you request Advance Standing.  No more than six (6) units may be granted for Advance Standing in a Master Degree Program:

I will be using my VA benefits.

I certify that I have personally completed this application and the information given is correct.

Date of Application [MM/DD/YY]:

Signature of Applicant (for printed copies)

There is a $50.00 nonrefundable application processing fee. All applications must be submitted electronically. To pay by check, please also print a copy of the completed form and mail to the address above with your check.
Application Fee Payment Options
ABOUT SSL CERTIFICATES	Credit Card	Credit Card Type: Select Card Type Visa MasterCard American Express Discover Name of Cardholder: Credit Card Number: Expiration [MM/YY]:
Check Enclosed
*How did you hear about us?
Internet (If so, which search engine)
Print media (which magazine or journal)
Direct mail
Personal referral (name of person)
Conference/Trade Show (which one)
Other
All data entered on AGU forms is encrypted before being sent over the internet, to protect the security of your information.