University Admission Form

HBIUS Admission

Please fill in the form carefully and make sure all the information is accurate
Name*

First NameFamily Name
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Country*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Current Employer

Name

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Number
Mobile Phone*
E-mail*
example@example.com
Last 4 Digits of SS or Passport Number or Government ID Number if you have one
Place Passport number or SS, this field is required
Are you a permanent resident of the US?

YesNo
Were you Referred by someone, please write their name below *
You can put your name or the person who referred you
Academic Information

Please choose one area of study.
If you don't see the program you desire, then write it in.
Solon Destiny Foundation Grant Opportunity Bachelor Programs
Bridging the Gap for LPNs
Youth Empowerment Scholarship Program Age 16 - 25
Certificate Programs you choose to pursue
HBIU Medical Institute. Programs you choose to pursue
Diploma Programs
Associate Programs
Bachelor Programs
Master Programs
Doctoral Programs
Ph.D. Programs
Honorary Programs
Flexible Path/Prior Learning
Previous Degree Earned

BachelorsMasters
Previous University Name
Year (FROM)

MonthDayYear
Year (TO)

MonthDayYear
Attach Documents
Admission Type
Copies of your High school record (if you have) (All transcripts in single file PDF format)

Cancelof
Official Transcripts from all colleges/Universities attended (All transcripts in single file PDF format) (THIS DOES NOT APPLY TO THOSE SEEKING A HONORARY DEGREE.)

Cancelof
Copy of Government ID

This field is required
Cancelof
Copy of Headshot Picture

This field is Required
Cancelof
Recommendation Letter, (1) (THIS DOES NOT APPLY TO THOSE PERSUING THE YOUTH PROGRAM, DIPLOMA, CERTIFICATE OR ASSOCIATE.)

This is for students pursuing a Master or Doctoral leave studies
Cancelof
Recommendation Letter, (2) (THIS DOES NOT APPLY TO THOSE PERSUING THE YOUTH PROGRAM, DIPLOMA, CERTIFICATE OR ASSOCIATE.)

This is for students pursuing a Master or Doctoral leave studies
Cancelof
Recommendation Letter, (3) (THIS DOES NOT APPLY TO THOSE PERSUING THE YOUTH PROGRAM, DIPLOMA, CERTIFICATE OR ASSOCIATE.)

This is for students pursuing a Master or Doctoral leave studies
Cancelof
Copy of GRE, if you have (THIS DOES NOT APPLY TO THOSE SEEKING A HONORARY DEGREE.)

Cancelof
Copy of Resume ( is required if you are doing a Master or Ph.D. Program or honorary degree )

This is for students pursuing a Master or Doctoral leave studies
Cancelof
Copy of TOEFL/IELTS ( if you have) (THIS DOES NOT APPLY TO THOSE SEEKING A HONORARY DEGREE.)

This is only for International Students that will be studying aboard
Cancelof
Statement of Purpose

This field is Required, BA, MA, Ph.D. Students
Cancelof
Signature

Powered by Jotform SignClear
Thanks for submitting your application, Click on the file to download, this will give you more information regarding our registration process

Application fee

Undergraduate Application Fee

$50.00 Quantity

Graduate Application Fee

$100.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

HBIUS Admission

Academic Information

Attach Documents