7245 College St. Lima, NY 14485
Main Phone» 585.582.1230
Admissions» 1.800.670.ELIM

Online Application
Step 1
 Personal Information
Step 2
 Education and Church Information
Step 3
 Employment and Financial Information
Step 4
 Health Information and Interests
Step 5
Personal Statment
Married Student
International Students		 Untitled Page

* Indicates a required field

Untitled Page
*Please type your full name here for ID purposes:

Employment Information:
1.
 Present Employer:
Name of Company:
Address:
Telephone Number:
Your title or type of work:
Number of years employed at this company:
2.
 List your employment for the past five years:
Employer City & State Type of Work Dates (From-To)

Financial Information:
3.
 We recommend that each student have semester fees (tuition, room/board, books, etc.) paid in full at the time of registration for each semester. Fall term fees are due at August Registration; Spring term fees are due at January Registration.
Will you be able to pay for your first semester in full at Registration?
If you answered “no” you will need to commit to our payment plan prior to Registration.
4.
 Indicate the source of funds and list approximate amounts (in US funds) available from each source:
Savings:
$
 Part-time work:
$
Parents:*
$
 VA Benefits:
$
Help from Church:*
$
 Social Security (monthly):
$
Other* (please note):
5.
 If a student is in a position where they cannot pay semester fees in full at Registration, they must contact the Admissions Office (before Registration) about payment plans and loans. Approval of a student’s financial plan by the Dean of Administration is required each semester. Once you submit your application, a Student's Statement of Financial Responsibility will be sent to you. You must sign and return this form to the Admissions Office.
6.
 Do you have any indebtedness which you cannot meet before you enroll?
If yes, complete the following:
Amount: $ To Whom:
Monthly Payments: $ Date of Completion:
How Indebtedness will be met:
Amount: $ To Whom:
Monthly Payments: $ Date of Completion:
How Indebtedness will be met:
Amount: $ To Whom:
Monthly Payments: $ Date of Completion:
How Indebtedness will be met:
Amount: $ To Whom:
Monthly Payments: $ Date of Completion:
How Indebtedness will be met: