Casa Loma College

Online App - MRI


CASA LOMA COLLEGE - Online Application for Admissions
6725 Kester Ave., Van Nuys, CA. 91405
Phone: 818-785-2726 / Fax: 818-785-2191
https://www.casalomacollege.edu
Your responses will be kept private and secure. (Personal information should match government issued ID) There is a non-refundable processing fee of $100.
Program of Interest


Personal Information
Social Security Number:
 Date of Birth:
Legal Last Name:
First:
MI:
Home Address:
City:
State:
Zip code:
Primary Phone:
Secondary Phone:
 
Do you have a different Mailing Address?
Mailing Address:
City:
State:
Zip code:
Email Address:
Sex Assigned at Birth:

Are you 18 years of age or older?

Parent/Guardian Last Name:
First:
MI:

Parent/Guardian Address:

City:
State:
Zip code:

Parent/Guardian Phone:


 
 
Citizenship


Demogrpahics





Previous Education















 



Financial Aid
   
 










I hereby certify that the answers and other information on this application are true and correct and that I understand any misrepresentation or falsifying of facts on my part make me ineligible for enrollment into Casa Loma College. I also understand that if upon my enrollment, false information was deemed to have been provided; I will be terminated from the college.

 

For Casa Loma College Use Only
Date:

Program:

Anticipated Class ID:

Admissions Rep:

Dir. of Admission Approval:

Processing Fee Received:
Yes ¨ No ¨
Date:Received By:
 

Leave this empty:

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Signature Certificate
Document name: Online App - MRI
lock iconUnique Document ID: e72a4b847923246dffaee10e355a87c81b63bb49
TimestampAudit
December 3, 2018 2:21 pm PSTOnline App - MRI Uploaded by James Dugan - support@casalomacollege.edu IP 45.31.0.252