Purdue University Global Application
This entire form must be completed and submitted to the Admissions Department as part of your Purdue Global record. Please print
legibly. This Application shall become effective upon the date of your signature and will automatically terminate if you do not commence
classes within 180 days of your original start date.
Personal Information
NAME: ________________________________________
Bolo Poth Deng PRIOR/MAIDEN NAME (IF APPLICABLE): _____________________________
Deng
STREET ADDRESS: _______________________________________________________________________________________________
6003 Gainsborough Rd
CITY: ________________________________________
Amarillo STATE: ________________________________
Texas ZIP: ________________________
79106
CVUE STUDENT NUMBER: ________________________
42837774 LAST 4 DIGITS OF SSN: _____________
3700 DATE OF BIRTH: ______________
01/01/1979
EMAIL: __________________________________________________________________________________________________________
bolopd@[Link]
WORK TELEPHONE: _____________________
(701) 205-9077 CELL TELEPHONE: ________________
EMPLOYER: ______________________________________________________________________________________________________
Tyson
ARE YOU HISPANIC/LATINO? [ ] YES [ ✘] NO
PLEASE SELECT ONE OR MORE OF THE FOLLOWING RACES: [ ] AMERICAN INDIAN OR ALASKA NATIVE [ ] ASIAN
[ ✘] BLACK OR AFRICAN AMERICAN [ ] NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER [ ] WHITE
CITIZENSHIP STATUS (OPTIONAL): __________________________
Eligible Noncitizen COUNTRY OF CITIZENSHIP (OPTIONAL): ____________________
Sudan
U.S. MILITARY AFFILIATION: ___________________________________________
Non Military BRANCH: __________________________________
RANK: _____________________________________________________________ DATE OF SEPARATION: ________________________
Educational Background
High school graduation or its equivalent is a requirement for admission to Purdue Global.
HIGH SCHOOL: ________________________________________________________________
"Fargo North high" GRADUATION DATE: _______________
05/2004
CITY: ________________________________________________________
Fargo STATE: ______________________ZIP:
North Dakota __________________
POSTSECONDARY EDUCATION
LAST EDUCATIONAL INSTITUTION: __________________________________________
Rasmussen College Fargo,ND DATES ATTENDED: ____________________
03/2006 - 03/2007
MAJOR OR SPECIALIZATION: ________________________________________________
Business Administration DEGREE OBTAINED: ___________________
Some credits but no degree
CITY: ________________________________________________________
Fargo STATE: ______________________ZIP:
North Dakota __________________
EDUCATIONAL INSTITUTION: _______________________________________________ DATES ATTENDED: _____________________
MAJOR OR SPECIALIZATION: _______________________________________________ DEGREE OBTAINED: ___________________
CITY: _________________________________________________________ STATE: ______________________ ZIP: _________________
EDUCATIONAL INSTITUTION: ____________________________________________ DATES ATTENDED: ________________________
MAJOR OR SPECIALIZATION: ____________________________________________ DEGREE OBTAINED: ______________________
CITY: _________________________________________________________ STATE: ______________________ ZIP: _________________
RETURNING STUDENTS ONLY
HAVE YOU ATTENDED ANOTHER COLLEGE SINCE LEAVING PURDUE GLOBAL? [✘] NO [ ] YES
COLLEGE: ____________________
DATES ATTENDED: ____________________________________________ APPROXIMATE # OF CREDITS: _______________________
CITY: ___________________________________________________________ STATE: ______________________ ZIP: ______________
NOTE: IF YOU WISH TO TRANSFER THESE CREDITS, AN OFFICIAL TRANSCRIPT MUST BE SENT TO PURDUE GLOBAL.
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Programs
Please indicate your program and concentration, population focus area, or micro-credential:
PROGRAM OF STUDY: ____________________________________________________________________________________________
Associate of Applied Science in Information Technology
Note: Some programs require students to pass a criminal background check; admission to program is not guaranteed.
CONCENTRATION/POPULATION FOCUS AREA/MICRO-CREDENTIAL*: ______________________________________________________
PREVIOUS PROGRAM OF STUDY (RETURNING STUDENTS ONLY): ______________________________________________________
LENGTH IN CREDIT HOURS†: _________________
90
*If not indicated, concentration or population focus area to be determined by the end of the second term.
†Length in credit hours is estimated and is not guaranteed. Additional prerequisites or other credits may be required.
Educational Funding Plan
At Purdue Global, we understand that earning your degree is a significant investment, and we offer many ways for you to fund
your education. Please select your primary, secondary, and/or additional funding sources. Please read the instructions for each section
carefully before making your selection. Please note that these options are not a guarantee or confirmation of eligibility.
Primary Funding Options
___ 100% Out of Pocket—Students wanting to utilize their own funds to pay for their education are encouraged to select this
option.
___ Federal Financial Aid (Grants and Loans)—Federal financial aid is a combination of loan and grant options. The Federal Direct Loan
program includes Subsidized, Unsubsidized, Parent PLUS, and Graduate PLUS loans. Purdue Global also participates in
the Federal Supplemental Educational Opportunity Grant (FSEOG) and Pell Grant programs. Eligibility requirements vary and
must be met prior to awarding.
___ Military Benefits—Servicemembers, veterans, and dependents of servicemembers may fund their education using military educational
benefits. Students utilizing GI Bill benefits for the first time must apply with the VA prior to enrollment. Students are also responsible for
notifying their Advisor if/when there is a change in military benefits/status.
X Employer Tuition Assistance—Many employers offer tuition reimbursement for employees seeking to increase skills and knowledge.
___
You must abide by your employer’s terms and conditions which may include eligibility based on, among other policies,
application submission, employment status, length of employment, funds availability within the designated period, required payments
and financial obligations as a student, GPA requirements, and employer’s stipulations about applying for and/or receiving
federal financial aid. Specific terms and conditions will be provided to you prior to completing your enrollment. See your employer
for details
___ Scholarships—Unlike student loans, scholarship funds do not have to be repaid. All of the funds you receive apply directly toward
paying your tuition.
___ Other ______________________________________________________________________________________________
Secondary Funding Options
___ Partial Out of Pocket—In the case that other finance options do not cover the entire cost of tuition, books, and fees, or if you’ve
elected to reduce the amount of debt you accrue during the course of your education, select this option.
___ Federal Financial Aid (Grants and Loans)—Federal financial aid is a combination of loan and grant options. The Federal Direct Loan
program includes Subsidized, Unsubsidized, Parent PLUS, and Graduate PLUS loans. Purdue Global also participates
in the Federal Supplemental Educational Opportunity Grant (FSEOG) and Pell Grant programs. Eligibility requirements vary
and must be met prior to awarding.
___ Military Benefits—Servicemembers, veterans, and dependents of servicemembers may fund their education using military educational
benefits. Students utilizing GI Bill benefits for the first time must apply with the VA prior to enrollment. Students are also responsible for
notifying their Advisor if/when there is a change in military benefits/status.
___ Employer Tuition Assistance—Many employers offer tuition reimbursement for employees seeking to increase skills and knowledge.
You must abide by your employer’s terms and conditions which may include eligibility based on, among other policies, application
submission, employment status, length of employment, funds availability within the designated period, required payments and financial
obligations as a student, GPA requirements, and employer’s stipulations about applying for and/or receiving federal financial aid.
Specific terms and conditions will be provided to you prior to completing your enrollment. See your employer for details.
___ Scholarships—Unlike student loans, scholarship funds do not have to be repaid. All of the funds you receive apply
directly toward paying your tuition.
___ Other _____________________________________________________________________________________________
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Alternative Funding Options
___ Partial Out of Pocket— In the case that other finance options do not cover the entire cost of tuition, books, and fees, or if you’ve
elected to reduce the amount of debt you accrue during the course of your education, select this option.
___ Employer Tuition Assistance—Many employers offer tuition reimbursement for employees seeking to increase skills and knowledge.
You must abide by your employer’s terms and conditions which may include eligibility based on, among other policies, application
submission, employment status, length of employment, funds availability within the designated period, required payments and financial
obligations as a student, GPA requirements, and employer’s stipulations about applying for and/or receiving federal financial aid.
Specific terms and conditions will be provided to you prior to completing your enrollment. See your employer for details.
___ Scholarships—Unlike student loans, scholarship funds do not have to be repaid. All of the funds you receive apply directly toward
paying your tuition.
___ Other ______________________________________________________________________________________________
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PLEASE READ ALL SECTIONS BELOW BEFORE SUBMITTING YOUR APPLICATION.
Funding
TUITION AND FEES: The tuition and fees for your program are included in the Tuition and Fees rates located at
Undergraduate and Graduate Tuition and Fees. Students who take courses offered by other schools within Purdue
Global may be charged a different tuition rate than that for their program of study. The tuition per credit hour/term is
subject to change. Tuition and fees are subject to change after 30 days’ advance notice. This 30-day notice does not apply
to student-initiated changes such as relocation or program changes.
This amount does not include costs incurred due to program changes or repeated classes, fundamental courses, or
multiple concentrations/ population focus areas. Students outside the United States or U.S. Territories will be responsible
for the cost and the shipment of instructional materials including returns and payment of customs duties or fees.
Refund Policy:
Applicants who are:
dismissed as a result of failing to meet the minimum entrance assessment score; or
undergraduate students who choose to withdraw by the end of week 3 of the first term (within Purdue Global
Commitment trial period); shall be entitled to a refund of all monies paid.
EMPLOYER ALLIANCE: Students who are enrolling through an employer alliance agreement should contact their
employer for Refund Policy details.
CHANGES TO ADMISSIONS POLICIES: CANCELLATION OF ADMISSIONS APPLICATION –Purdue Global reserves the
right to amend its admissions policies at any time, and to seek your acknowledgement and agreement to such amended
policies and/or to cancel this Application if you do not acknowledge and agree to such policy amendment prior to your
expected start date.
THREE-DAY CANCELLATION–An applicant who provides written notice of cancellation within 3 days (excluding Saturday,
Sunday, and federal and state holidays) of completing and acknowledging a Purdue Global Online Application for
Enrollment is entitled to a refund of all monies paid. No later than 45 days of receiving the notice of cancellation, the
school shall provide the 100% refund.
Indiana Residents – Six-Day Cancellation–An applicant who provides written notice of cancellation within 6 days
(excluding Saturday, Sunday, and federal and state holidays) of completing and acknowledging a Purdue Global
Online Application for Enrollment is entitled to a refund of all monies paid. No later than 30 days of receiving the
notice of cancellation, the school shall provide the 100% refund.
REQUESTING TO DROP A COURSE: Students may drop a course prior to or during the first 7 calendar days of the course
without any financial obligation. Students who request to drop a course beyond the first 7 calendar days will incur 100%
financial responsibility for the course.
ADMINISTRATIVE WITHDRAWAL FROM A COURSE: Any traditional course in which you do not log attendance by the
twelfth day of the term will be administratively removed from your schedule. Any module course in which you do not log
any attendance during the term you will be administratively removed after the end of the term. These courses will not
appear on your transcript and removal may have an impact on your financial aid eligibility.
At the end of the term, each traditional course without a grade posted or dropped with an "IP" grade will be
reviewed to determine if you finished the course or withdrew before finishing the course.
If you achieved an overall passing grade or received any points in the final two units of the course, you will be
considered to have finished the course and will be awarded the grade determined by the grade scale. (See
Academic Grades and Marks.)
If you did not receive any points in the final two units of the course, you will be considered to have withdrawn from
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the course and receive a "W" grade. No refunds will be provided.
ADMINISTRATIVE WITHDRAWAL FROM THE PROGRAM: If you are enrolled in a non-ExcelTrack program, you will be
administratively withdrawn from your program if you have not logged attendance in any classes by the end of the twelfth
day of the term. In an ExcelTrack program, if you do not log attendance in the first three weeks of a term, you will be
administratively withdrawn.
If you receive withdrawal grades for all courses in a term, you will be administratively withdrawn from your
program at the end of that term.
If you take only module courses in a term, you will be administratively withdrawn from your program if you do not
earn at least one passing grade in the term.
If you take both traditional and module courses in a term, receive all withdrawal grades in your traditional
course(s), and do not earn at least one passing grade in your module course(s), you will be administratively
withdrawn from your program.
If you are enrolled in a program on the independent model, you are not subject to these administrative
withdrawals.
Any refunds will be assessed in accordance with the chart below.
NOTICE TO STUDENTS
Return of Title IV Financial Aid: When you officially withdraw or are administratively withdrawn from the program, the
last date of attendance (LDA) will be used as the date of withdrawal. If you withdraw or are dismissed from the University
up through 60% days in any payment period and received federal financial aid in the form of grants or loan funds, federal
law requires that the University, and in some cases you, the student, return funds you did not earn to the U.S. Department
of Education. In these situations, please refer to the Purdue Global Financial Aid Information Guide. The last date of
attendance is used in calculating any refund amount.
All refunds due will be made within 45 days of the University determining you are no longer enrolled.
TUITION REFUND CHART
If you have completed the Purdue Global Commitment period or are a continuing student, you are subject to the Purdue
Global Refund Policy and the Tuition Refund Chart.
This policy applies to all students, including military students using tuition assistance with the exception of
deployed or mobilized servicemembers and their spouses with dependent children residing in Iowa. Iowa residents
deployed or mobilized servicemembers and their spouses with dependent children should refer to the applicable
policy below. International students should refer to their International Admissions Application.
The institutional refund (tuition) is based on the same formula as the Title IV (R2T4) formula, which is based upon
the actual daily percentage of the term attended: days completed (LDA) divided by the length (days) of the term.
Days within the winter break are not counted toward the term period.
STUDENTS WITHDRAWING
REFUND
(10-WEEK CALENDAR)
Through the first 7 calendar days of the term 100% tuition for the term
Tuition will be prorated/refunded based upon the
number of calendar days attended in the term/total
With attendance posted during the term days in the term. Attendance greater than 60% is
considered fully earned tuition for that term, and no
refund will be given.
With attendance posted after the first 7 calendar days
of the term and an academic grade has been received
No tuition refund
for a traditional course or a passing grade has been
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received for a module course within the term
For Iowa Servicemembers and Their Spouses With Dependent Children
Iowa’s Military Refund Policy under Iowa Code 256.183(1)(g) and Iowa Administrative Rule 283-21.3(5) state that the
University shall offer not less than the following options to a student who is a member, or the spouse of a member if the
member has a dependent child, of the Iowa national guard or reserve forces of the United States and who is ordered to
national guard duty or federal active duty:
Withdraw from the student’s entire registration and receive a full refund of tuition and mandatory fees.
Make arrangements with the student’s instructors for course grades, or for incompletes that shall be completed by
the student at a later date. If such arrangements are made, the student’s registration shall remain intact and
tuition and mandatory fees shall be assessed for the courses in full.
Make arrangements with only some of the student’s instructors for grades, or for incompletes that shall be
completed by the student at a later date. If such arrangements are made, the registration for those courses shall
remain intact and tuition and mandatory fees shall be assessed for those courses. Any course for which
arrangements cannot be made for grades or incompletes shall be considered dropped and the tuition and
mandatory fees for the course refunded.
Return of Unearned Tuition Assistance: Military Tuition Assistance (TA) is awarded under the assumption that you will
attend school for the entire period for which the assistance is awarded.
If you withdraw or are dismissed, you may no longer be eligible for the full amount of TA funds originally awarded.
Purdue Global will return any unearned TA funds on a proportional basis through at least the 60% point of the
period for which the funds were provided, with unearned funds returned based upon your last date of attendance
(LDA).
If you stop attending due to a military service obligation, and notify Purdue Global of that obligation, Purdue
Global will work with you to identify solutions that will not result in a debt balance for the returned portion.
Calculation: When you officially withdraw or are administratively withdrawn from a course, the LDA will be used as the
date of withdrawal. Once LDA has been determined, Purdue Global will recalculate your TA eligibility based on days
attended in accordance with the Military Tuition Assistance Refund Chart.
Return of Funds: Determining eligibility for TA is course specific. The start and end dates will be used for each course to
determine eligibility. Using the Military Tuition Assistance Refund Chart, Purdue Global will be required to return some or
all of the TA awarded to you if you did not complete at least 60% of each course, possibly creating a debt balance on your
Purdue Global ledger.
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PLEASE READ ALL SECTIONS BELOW BEFORE SUBMITTING YOUR APPLICATION.
Acknowledgements
Proof of Prior Degree
Students enrolled in a program for which a prior degree is required must furnish an official transcript indicating receipt of
a comparable degree from a college or university accredited by a regional or national accrediting agency recognized by
the U.S. Department of Education no later than 2 days prior to the expected start date. If by the deadline a student is
unable to provide an official college transcript showing their prior degree completion, Purdue Global will attempt to use an
unofficial transcript the student provided during enrollment, and compare it to other official record sources, to confirm
that the degree completion requirements for the program have been met. If the degree cannot be verified by 2 days prior
to the scheduled start date, the student will need to defer their start date.
International Applicants
International applicants may be subject to further requirements. International applicants should consult the International
Applicants policy within the Admissions Information section of the University Catalog, as well as program-specific
requirements.
Graduation Requirements
The candidate for graduation must: Complete all requirements for their program of study within the maximum time frame
permitted and attain a cumulative grade point average (CGPA) for the program as defined in the Purdue Global Catalog,
and Attend career services and financial aid exit interviews, if applicable. Some programs may have additional
requirements that must be met.
Additional Technology Requirements
Along with the Technology Requirements listed in the Catalog, all students should review and be aware of any additional
software and hardware requirements for their classes prior to enrollment. For a complete listing of additional
requirements, visit Technology Requirements for Individual Courses - Purdue Global.
Any holder of this consumer credit contract is subject to all claims and defenses which the debtor could assert against the
seller of goods or services obtained pursuant hereto or with the proceeds, hereof. Recovery hereunder by the debtor shall
not exceed amounts paid by the debtor (FTC Rule effective 5-14-76).
I acknowledge:
I have received and read the Tuition and Fees rates located at Undergraduate and Graduate Tuition and
Fees and understand that I will be held responsible for the requirements and policies in the Purdue Global
Catalog, which is available at Purdue University Global Academic Catalog.
Should I relocate from the primary address noted at the time of enrollment I must update my address via the PG
Campus student portal within the first 30 days of moving to have my primary address updated.
I must review my program page in the University Catalog to determine any applicable professional licensure
requirements for my new primary address and that certain programs that are designed to meet professional
licensure requirements in one state may have different requirements in another state.
While traveling or relocating outside of the U.S., I may be unable to access the Purdue Global campus, services,
and courses from countries or regions subject to economic and/or trade sanctions by the Office of Foreign Assets
Control (OFAC) or other authorities.
If I am an employee, eligible family member, or member of a preselected organization or postsecondary institution
with which Purdue Global has an educational relationship–I may be required to provide proof of eligibility to obtain
a tuition reduction before or during my enrollment at Purdue Global.
I authorize Purdue Global or a third-party employment verification agency, upon or after my graduation, to contact
my place of employment for the purpose of verifying my employment.
I must provide a copy of a valid, government-issued identification and the name in my student record must match
my legal first and last name from my ID. This is not required for International students.
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Indiana Residents ONLY:
I understand that to receive a residency-based tuition discount I must provide a copy of official documentation that
includes my name and current address.
Criminal Justice Enrollees ONLY:
I understand that graduates of Purdue Global criminal justice programs are not eligible to attend police academies in
Minnesota.
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