Applying for: Fall Term - August Spring Term - January Summer Term - May
- Year: Year 2008 2009 2010

Admission Status: Freshman Transfer Transient Non-Degree Seeking (4 yr. degree Graduate) Re-Admit (only previous attended Benedict College)

PERSONAL DATA:

Email address:

Social Security #: Date of Birth: (Date Format: MM/DD/YYYY, MM = Month, DD = Day of Month and YYYY = Year; example: 09/29/1982 for September 29, 1982)
Place of Birth:

Name: Last    First
MI

Address:

City: State/Province: Choose a State Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory
Zip Code: County (not Country):

Phone Number:

* This information is voluntary and is not used as a factor in admission decisions nor is it used in a discriminatory practice.

Gender: Male Female

*Religious denomination: Baptist Methodist Catholic Other

*Racial or Ethnic Origin: Black White Asian Hispanic American Indian Other

Intended Major: Accounting Biology Business Administration - Management Concentration Business Administration - Marketing Concentration Chemistry Child and Family Development Computer Engineering Computer Information Science Computer Science Criminal Justice Early Childhood Education Economics - Finance Concentration Electrical Engineering Elementary Education English Environmental Health Science History Interdisciplinary Studies Mass Communication - Broadcast Concentration Mass Communication - Print Concentration Mathematics Music Education - Instrumental Concentration Music Education - Theater Concentration Music Education - Vocal/Choral Concentration Physics Political Science Psychology Public Health Recreation Religion and Philosophy Social Work Sociology Studio Art Undecided

Please list the high school you are attending or graduated from and/or all colleges you have attended (School/College Name, Address, City, State, Zip, Graduation Date):

NOTE: Please include address for school listed above .

Are you a veteran? Yes No      Are you a United States citizen? Yes No

How did you hear about the Benedict College Continuing Education Program (Please specify)? College recruiter Father attended Benedict Mother attended Benedict Benedict Alumnus Benedict Student Benedict Faculty/Staff Benedict Website High School counselor Church Poster/Flyer Magazine/Newspaper Radio Television Other