All fields in bold are required.
Please take a minute to review the information above and make sure it is all correct.
A copy of this page will be emailed to you for your records.
Sullivan University is an equal opportunity institution and does not discriminate against persons because of race, age,
religion, sex, handicap, color or national origin. Completion of related items is optional, however it will aid in the prompt
processing of your application and will be used for federal, state and Affirmative Action reporting purposes.