Personal Information

Date of Birth
Social Security Number
Your Social Security number is required for financial aid.
Are you a veteran, or are you currently serving in the U.S. Armed Forces?

Permanent/Legal Address

Is your mailing address the same as above?

Contact Information

Preferred Phone

Preferred Phone Number

Alternate Phone

Alternate Phone Number


I am:

Ethnicity (optional)

This information is used only for statistical purposes and to provide information required by the U.S. Department of Education under the provisions of Title VI of the Civil Rights Act. You are not required to answer; however, an answer would be greatly appreciated. Houston Baptist University provides educational opportunities without regard to disability, age, race, sex or national or ethnic origin.

If you wish to be identified with a particular ethnic group, please select the choice that most accurately describes your heritage. No information you provide will be used in a discriminatory manner.
Are you Hispanic or Latino?
Select one or more of the following races:

Religion (optional)