One Year Survey of World Religions Application Please print this form. Complete all information, and return it with a recent photo and your non-refundable $150 application fee, payable to "The New Seminary". Credit cards are accepted with an additional $10 one time fee. Mail form, photo and check to: Registrar, The New Seminary 2576 Broadway, #344 New York, New York 10025 (212) 222-3711   Name: _____________________________________________________________ Address: ___________________________________________________________ City: _____________________________ State: _____________ Zip:___________ Home Phone: ( ) _______________________ Work Phone: ( ) _______________________ Fax: ( ) _______________________ E-mail: ___________________________________ Enclose check, or specify: Credit Card____________________________________Type__________Exp.Date_______ Signature_________________________________________ Occupation: _______________________________________________ Date of Birth (Optional): _________ How did you learn about The New Seminary? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ I wish to enroll as a: __ Attending Student __ Correspondence Student Please let us know your reasons for requesting enrollment in this program and what you hope to get out of this course. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Signature: __________________________________ Date: ________________________