4505 Katella Ave. Los Alamitos, CA 90720 (714)947-5311

Cottonwood College Application

Evening Program

For more information, please visit our website at www.cottonwoodcollege.org or give us a call!

Biographical Information

Please type your full legal name.


The school does not discriminate on the basis of race, color, gender, national or ethnic origin, handicaps or disability, age, marital, or veteran status in any of its policies, procedures, or practices.

Marital Status

Church Affiliation

Ministry Information

(Ministry Information)

Personal References

Please list two people, other than family members, who have known you for a year or more. (One of the references must be your Pastor or a Ministry Leader.)

Educational History

Employment History

Please list your employment history for the past three years beginning with your current employer.

Financial Information

Emergency Contact

Personal Statements

Legal and Health

Medical Consent

I, the undersigned, do hereby grant full permission to Cottonwood College or any related or consulting physician to render any emergency medical aid, care or treatment that they deem necessary. I also understand that should extended hospitalization be required, I grant complete permission for such care and treatment to be given. This consent I give freely and voluntarily, fully knowing and understanding all the above and its relation to and effect upon me.

Statement of Truth

I hereby apply to Cottonwood College and certify that to the best of my knowledge the information given in this application is correct. If I am admitted, I agree to abide by the regulations and standards of Cottonwood College, including the Standards of Conduct found on the bottom of www.cottonwoodcollege.org. I understand that all items submitted to Cottonwood College as part of this application process become the permanent property of the College and it will not be returned. If Cottonwood College is notified that any of the information contained on this application is false, it will be grounds for immediate dismissal.

Photo Release

I hereby grant permission to Cottonwood Church (the "Church") to use my photograph, likeness, image, voice or performance on its Internet website, CD or DVD labels, video tape or film clips, advertisements or other official Church publications at the sole discretion of the Church and to be used in whole or in part of any and all broadcasting, audio/visual, and/or exhibition purposes in any manner or media, in perpetuity, throughout the world. 1. I have the right, capacity, and authority to enter into this agreement (herein after called "Agreement") and that my appearance and the rights I have granted in this Agreement will not conflict with or violate any commitment or understanding I have with any other person or entity. 2. I understand that once my image appears on the Church's website, the image can be downloaded by any computer user. I expressly release the Church, its officers, directors, employees, volunteers and agents from any and all claims arising out of the use of my photograph or image on the Church's website. I agree to indemnify and hold harmless the Church, its officers, directors, employees, volunteers and agents from and against all claims, losses, expenses and liabilities of every kind including reasonable attorney's fees arising out of the inaccuracy or breach of any provision of this Agreement. 3. In consideration for my appearance and/or performance on the Church's Internet website, CD or DVD labels, video tape or film clips, advertisements or other official Church publication and all rights granted hereunder, I do not require or expect any monetary or financial payment or incentive or benefit but consider my appearance and/or performance to be a form of service to the Church. 4. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. This Agreement represents the entire understanding of the parties and may not be amended unless mutually agreed to by both parties in writing. 5. I have fully informed myself of the contents of this PHOTO RELEASE by reading it before I signed it.

Student Acknowledgment

Standards and Policies: I understand and agree that it is my responsibility to familiarize myself with the policies and procedures contained in the Cottonwood College Catalog (available online at cottonwoodcollege.org) and to follow those policies and procedures. I understand that by signing this acknowledgment form, I am agreeing to the following: 1. To the best of my abilities I will fulfill all the requirements of the academic program. 2. I will comply with the Policies and Procedures outlined in the Cottonwood College Catalog. 3. I will comply with the Standards of Conduct. Proprietary Information: I understand that all student handouts, teaching notes, course outlines, quizzes, exams, or any other related Cottonwood College documents are proprietary information and are the sole property of Cottonwood College. I understand that I am not entitled to copy, duplicate, access or otherwise appropriate such proprietary information for the benefit of any third party. I further understand that Cottonwood College maintains the right to terminate my enrollment should I breach any of the above stated standards and policies.


In an essay of 2-3 paragraphs, respond to the following: Share your salvation experience. Why have you chosen to apply at Cottonwood College? What do you hope to accomplish at Cottonwood College?