Data Collection Form-Employee or Spouse of Employee

Home Address:


Phone numbers:

Marital Status

Ethnic (we are required to request this information by Federal Statute)
Religious Denomination:
Are you seeking a degree?:
Degree Already Earned?:
Year & College where degree was earned
Have you ever taken any classes through the university (this includes Continuing Education, Lifelong Learning, Wilmar-Extension, Newman Center Extension, Military Science, SJU Prep School Program, St. Cloud Hospital School of Nursing, or Special Diocese)

Courses Requested

Alternate Courses to be considered if your first choice is unavailable