Program of Interest:
Choose a Program
First Name:
Last Name:
Email:
Best Time to Call:
--choose--
morning
noon
midafternoon
evening
Home Phone:
Work Phone:
Address1:
Address2:
City:
State:
Please Select
Alabama
Alaska
Arizona
Arkansas
AA (U.S. Military-America)
AE (U.S. Military-Europe)
AP (U.S. Military-Pacific)
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Country:
choose
United States
Outside U.S.
Highest Level of Education Completed:
Please Select
Haven't completed High School
G.E.D.
High School Diploma
Some College, 1-29 Credits
Some College, 30-59 Credits
Some College, 60-89 Credits
Some College, 90+ Credits
Associate
Bachelor
Master
Doctorate
Year of HS Graduation:
Please Select
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
Desired Start Date:
Please Select
Immediately
1-3 Months
4-6 Months
7-12 Months
More than 1 Year
Not Sure
Age:
Please Select
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
Military Affiliation:
Please Select
No Military Affiliation
AF - Active Duty(AD)
AF - Civilian
AF - Selective Reserve(SR)
AF - Spouse of AD or SR
AF - Veteran
AR - Active Duty(AD)
AR - Civilian
AR - Selective Reserve(SR)
AR - Spouse of AD or SR
AR - Veteran
CG - Active Duty(AD)
CG - Civilian
CG - Selective Reserve(SR)
CG - Spouse of AD or SR
CG - Veteran
MC - Active Duty(AD)
MC - Civilian
MC - Selective Reserve(SR)
MC - Spouse of AD or SR
MC - Veteran
NV - Active Duty(AD)
NV - Civilian
NV - Selective Reserve(SR)
NV - Spouse of AD or SR
NV - Veteran
Are you a US Citizen?
Please Select
Yes
No
Do you have an undergraduate degree in this field?
Please Select
Yes
No
Years of Work Experience:
Please Select
None
1 Year
2-4 Years
5-10 Years
10+ Years
Do you possess a current and valid RN license?
Please Select
Yes
No
Do you have an undergraduate degree in nursing?
Please Select
Yes
No
Do you have an undergraduate degree in education?
Please Select
Yes
No
Do you possess a teaching certificate?
Please Select
Yes
No
Years of Teaching Experience:
Please Select
None
1 Year
2-4 Years
5-10 Years
10+ Years
GPA for highest level of education:
Please Select
Less than 2.0
2.0-2.4
2.5-2.74
2.75-3.0
3.0 or Higher
Have you ever had a student loan?
Please Select
No
Yes, it is paid in full
Yes, it is in good standing
Yes, it is in default
I acknowledge that, by clicking the checkbox as my official signature, I consent to representatives of Grand Canyon University and EducationDynamics, LLC contacting me about educational opportunities via email, text, or phone, including my mobile phone number(s) provided above, using an automatic dialer, or pre-recorded message. Message and data rates may apply. I understand that my consent is not a requirement for any purchase.