College Application for Admission

Please use this Application for Admission to apply to Breining Institute certificate and/or degree programs.

We will not commence review of your application until we have received the non-refundable $75 Registration fee payment. You may authorize the charge to your credit card by providing your credit card information at Section 9, below, or you may send us a check or money order by postal mail after you have completed and submitted this application.

Application / Enrollment Periods

Addiction Studies Certificate (ASC) Program:

The ASC course is an open-application / open-enrollment program, to which you may apply and start at any time. You may apply for this course today using the form below.

Degree Courses (Associate, Bachelors, Masters and Doctorate):

The degree programs are restricted enrollment programs, to which you may apply once a year. The application period for the 2016-17 Academic Year is now closed, and the next application period will be during the month of July 2017 for the 2017-18 Academic Year, which will start September 2017. We will not be accepting or reviewing new applications for any of the degree programs until July 2017.

Section 1. Applicant Information
Section 2. Program
Section 3. Previous Formal Academic Education

Please identify the formal education institutions that you have attended, and include the certificates or degrees that you were awarded (if applicable). You will also need to provide us with formal transcripts from these institutions before we can complete your enrollment and/or award of any certificate or degree.

Please list here the names of the formal education institutions that you attended, and include the certificates and/or degrees you earned from those institutions, as well as the dates that they were earned.
Section 4. Major Employment History
Please list your major employment history, including the name(s) of your employer(s), your job title(s) and/or description of your duties, and the dates that you were employed by those respective entities.
Section 5. Personal Recovery Program (if applicable)
If applicable, please indicate any / all programs of personal recovery in which you are currently or were involved (please select all that apply).
Section 6. Payment Method
Please let us know if you intend to make tuition payments by Series or Courses, or if your employer, insurance company or other entity will pay for your tuition. We will need an Authorization to Bill (or similar documentation) if your employer, insurance company or other entity will be paying for your tuition.
Section 7. Statement of Intent
Please provide a short autobiography and statement about why you wish to enroll in the program you have selected.
Section 8. Supporting Documentation

In order to complete your application, we will need to receive:

  • 1. A letter of support from a colleague and/or counselor verifying your experience / interest in this field;
  • 2. A letter of support verifying active involvement in a recovery program (if applicable); and
  • 3. Official transcripts from formal education institutions at which you completed coursework.

You may send these documents to us by postal mail or email or facsimile.


Breining Institute – Admissions Office, 8894 Greenback Lane, Orangevale, California 95662-4019

Section 9. Registration Fee Payment

You may pay the $75 Registration Fee by providing your credit card payment information, below, or by mailing us a check or money order.

We will process the credit card payment as soon as possible, typically within one business day.

We will not commence review of your application until we have received the Registration fee payment.

You give permission to and authorize Breining Institute to charge $75 to the following credit card:


By submitting this form, I attest that the information I have provided above is true and authentic. I understand that if at any time it is determined that the information provided is materially misrepresented, any fees which have been paid will be forfeited, and certifications, degrees and/or credentials may be revoked.