Online Application for Admission

Apply Online - Step 3 to be filled out by the applicant
*Parent's/Guardian's Marital Status:
*Full Name of Father or Male Legal Guardian:
*Father's Address:
*Father's City, State, Zip Code:
*Father's Phone Number:
*Father's Email Address:
*Father's Employer and Occupation:
*Full Name of Mother or Female Legal Guardian:
*Mother's Address:
*Mother's City, State, Zip Code:
*Mother's Phone Number:
*Mother's Email Address:
*Mother's Employer and Occupation:
*Please list the names of any relatives who have attended Crossroads College:
*Have you received Jesus Christ as your Lord and Savior?
*Name of the Church You Currently Attend:
*Church Address:
*Church's City, State, Zip:
*Church Phone Number:
*Church Denomination:
*Name of Pastor:
*Name of Youth Pastor:
*Please enter your full name here to verify that all information contained in this application is accurate to the best of your knowledge and that you, the applicant, filled out all information
*Today's Date:
The remaining application forms can be downloaded from our website. If you would prefer to have the remaining forms mailed to you, please check this box:
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(Items marked * are required)

Crossroads College
920 Mayowood Road SW
Rochester, MN 55902, USA
Phone
(507) 288-4563 or (800) 456-7651

Copyright 2014 Crossroads College