Release Authorization Page 8
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13Please print and complete this form and return it to the Admissions department along with a small photo of yourself:
Pensacola Christian College
P.O. Box 18000
Pensacola, FL 32523
Name: ______________________________________________
Address: ____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
I certify that the information given on the application is complete and accurate. I also understand that I am financially
responsible for the payment of this account if the student listed above is accepted for enrollment.
Applicant’s signature: ______________________________ Date: ___________
Signature of parent, guardian, or sponsor: ______________________________
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