Last Name First Name M.I. Maiden Name
STUDENT INFORMATION
A $75.00 non-refundable fee must accompany this application. Make a check or money order payable, in U.S. funds, to California Coast
University; or make a payment via credit card. Remember to include your name on your check or money order. Applicants must be at
least 18 years of age and have graduated with a high school diploma or G.E.D. certificate to be admitted to the University.
Permanent Mailing Address
Date of Birth Social Security Number E-mail - Primary E-mail - Secondary
Home Phone Work Phone/Ext. Mobile Phone Gender
oMale oFemale
Will you be using tuition assistance through any of the following? If so, please check one.
o VA Benets oCompany Reimbursement oOther ____________________________
Ethnic Heritage o African-American o American Indian/Alaska Native o Asian/Pacic Islander
(optional)
oCaucasian o Hispanic o Other ______________________________
Please select one of the following certicate or degree programs:
Application for Admission
California Coast University - 925 N. Spurgeon Street - Santa Ana, CA - 92701 - Phone: (888) CCU-UNIV - www.calcoast.edu (Rev. 3/18) Pg. 1 of 2
How did you hear about CCU? If Referred, by whom? (Please be specic)
Company/Current Employer Title
City State
Zip Code/International Postal Code Country (If not U.S.A.)
I certify that I graduated with a high school diploma or G.E.D. certicate from the institution listed below:
__________________________________________________________________________________ in the year _____________.
Print name of your high school (or agency that awarded your G.E.D.) City, State
Have you ever been in the military?
o Yes oNo
Undergraduate Degrees Graduate Degrees
o A.S. Business Administration o M.A. Organizational Leadership
o A.S. Business Marketing
o A.S. Criminal Justice o M.B.A.
o A.S. General Studies o M.B.A. Business Marketing
o A.S. Health Care Administration o M.B.A. Health Care Management
o A.S. Psychology o M.B.A. Human Resource Management
oM.B.A. Management
o B.S. Business Administration
o B.S. Business Marketing o M.Ed. Administration
o B.S. Criminal Justice o M.Ed. Curriculum and Instruction
o B.S. General Studies
o B.S. Health Care Administration
o B.S. Management
o B.S. Psychology
o M.S. Criminal Justice
M.S. Psychology
o Ed.D. Educational Administration
o Ed.D. Educational Psychology
o Ed.D. Organizational Leadership
Undergraduate Certicates
o Business Administration
o Fundamentals of Criminal Justice
o Fundamentals of Finance
o Health Care Administration
o Fundamentals of Management
o Fundamentals of Marketing
o Fundamentals of Psychology
Graduate Certicates
o Business Administration
o Curriculum and Instruction
o Educational Administration
o Health Care Management
o Human Resource Management
o Management Studies
o Marketing Studies
o Organizational Leadership
o Psychology Studies
D. Cost per doctoral unit $290.00
PRIOR ACADEMIC EXPERIENCE
Previous Colleges / Universities Dates Attended Degree Awarded/Major Units of Credit Earned
Students outside the contiguous U.S. may only receive coursework electronically.
Outside the contiguous U.S. includes AK, AS, FM, GU, HI, MH, MP, PR, PW, and U.S. VIS.
I am applying for admission into the: _____________________________________________________________________ program.
(Enter the name of the program for which you are applying. Please double check the program choice.)
______________________________________________________________________ ______________________________________
Applicant’s Signature Date
By signing below, I certify that I am at least 18 years of age and to the best of my knowledge the information provided in this
application is accurate and complete. I do not possess any disabilities that would prevent me from successfully completing this
program. I understand that if this information or any other information upon which my admission is based is found to be inaccurate
or incomplete, California Coast University may rescind my certicate or degree. I hereby apply for admission to the program
selected on the front of this application and listed below. I understand that if accepted, I may enroll in the program offered and pay
my tuition at no interest with California Coast University. I am paying a non-refundable application fee of $75.00 and understand
that this application is valid for 30 days from the date of acceptance. If I do not enroll within 30 days, I will have to reapply for
future enrollment and will be subject to a $75 re-evaluation fee at that time. Should I decide to request an evaluation for an
alternate degree program, than the one listed on this application, I will be subject to a $75 evaluation fee.
TUITION AND APPLICATION FEES
PAYMENT INFORMATION
A. Application fee (non-refundable) $ 75.00
C. Cost per graduate unit $230.00
I am enclosing a $75.00 check or money order payable in U.S.
funds to California Coast University.
I am paying my $75.00 non-refundable application via credit
card. If paying by credit card, please complete the Authorization
one-time Credit Card Charge Form.
B. Cost per undergraduate unit $150.00
OFFICE USE ONLY
Recommended for Admission: __________________________________________________________ ______________________________
(Admissions Department CCU) Date
Accepted for Admission: _______________________________________________________________ ______________________________
(Academic Dean) Date
Any questions or concerns which have not been satisfactorily answered or resolved by the university should be directed to:
The Bureau for Private Postsecondary Education
P.O. Box 980818
West Sacramento, CA 95798
www.bppe.ca.gov
California Coast University - 925 N. Spurgeon Street - Santa Ana, CA - 92701 - Phone: (888) CCU-UNIV - www.calcoast.edu (Rev. 3/18) Pg. 2 of 2
Are you a previous California Coast University student? o YesoNo Student I.D. # __________________________
Highest Level of Education: o No college o Some college Degrees: o Associate’s o Bachelor’s o Master’s o Doctoral
Application for Admission