On-Line Admissions Form

Application for Admission and Scholarship

Please provide all of the following information.  Incomplete applications will not be accepted.  When complete, please click ONCE on the "Submit" button located at the bottom of the form.  To clear the form and start over, click once on the "Reset" button.  You will receive a confirmation notice if your information is successfully transmitted.  If you experience problems with this form, please contact the Bethany College Office of Admissions at 1-800-826-2281.

If you wish, you may also print this application form, fill out in blue or black ink ,and fee payment mail to:
Office of Admissions
Bethany College
335 East Swensson Street
Lindsborg, KS 67456-1897  

 Online applications do not require an application fee. Applications mailed will not be processed until a $ 20.00 application fee has been sent with the signed form.

You may also save this document in html format, complete off-line, and send as an attachment in an e-mail to the admissions office at admissions@bethanylb.edu. Sending the application as an e-mail attachment does not require an application fee.

YOU WILL RECEIVE WRITTEN CONFIRMATION OF YOUR APPLICATION VIA U.S. MAIL WITHIN ONE WEEK.

If you do not receive written confirmation, please call 1-800-826-2281 for assistance. Thank you for applying!

 Items marked with an asterisk * are required.

Biographical Information

Legal Name:
*First Name: Preferred Name:  Middle Initial:

Maiden Name:(if applicable)

* Last Name:

Permanent Address:
* Street Address:

* City:   County: * State:
* Postal Code:    * Country:

* Permanent Telephone:
* E-mail Address:
Cell/Alternate Phone:

Gender: Male: Female:

*Birthdate: Mo   Day  Year:  

* Citizenship: USA:   Other:

Visa Status:

If you are not a citizen of the United States and are already in this country, please specify your status:
Permanent resident/resident alien/immigrant/refugee
F-1 Student Visa:
Other:

Enrollment Information
* Are you applying as a: Freshman?:   or Transfer?   * Transfer Year?:

* Will you be attending: Full Time?:     or Part Time?:

* Will you be a: Resident?:    or Commuter?:

* Beginning in the: Fall?:     or Spring?:

Optional Information

Place of Birth: Marital Status:

 How would you describe yourself?:
White, Anglo, Caucasian (non-Hispanic)
Asian or Pacific Islander
Black (non-Hispanic)
Hispanic or Latino/Latina
American Indian or Alaska Native
Multi-Ethnic
Other:

Religious Affiliation:
Name of Church, Temple or Synagogue:
Address:

Education
* School you now attend:
Address:
*Graduation Date:

College Advisor:

Is your school: Public:       Private:      Parochial:
School Telephone:
Self Reported GPA:
ACT/CEEB Code:

Please list any other secondary schools, including summer schools, programs and institutes which you have attended since 8th grade.  Transfer applicants, please list high school and dates of attendance.

Name of School
Location (city, state, zip)
Dates Attended

Please list all colleges attended: (Please have official transcripts forwarded from each college)

College
State
Credit Hours
Dates Attended
Degree Received

Probable Major/Areas of Academic Interest
My tentative choice of major is......
Choice 1)
Choice 2)
Choice 3)

Family
Parents' Email Address:
Father's Full Name:
 Living?:
Home Address:
Occupation:
Name of College (if any):
Degree:
 Year:
Name of Grad School:
Degree:
 Year:
Mother's Full Name:
 Living?:
Home Address:
Occupation:
Name of College:
Degree:
 Year:
Name of Grad School:
Degree:
 Year:
If not with both parents, with whom do you make your permanent home?
Name:
Relationship:
Address:
Please check if parents are:
Separated:
Divorced:
Please give names and ages of your brothers and sisters.  If they have attended college, give the names of the institutions attended, degrees, and approximate dates.
Name
Age
College Name
Degree(s)
Year
Do you have friends or relatives who have attended or are now attending Bethany?  If so, please indicated below:
Name
Relationship
Dates Attended
             
Financial Aid and Scholarships
Do you intend to complete the Free Application for Federal Student Aid? (Note: The deadline for Kansas residents is March 15)
Yes:       No:
If yes, the appropriate form was/will be filed on (date):
If there are any unusual circumstances that will affect your family's financial status for the coming year, please indicate this special condition:
Would you like to be considered for an academic, art, athletic, music or theatre scholarship?
Yes:       No:
Are you of Swedish Ancestry?
Yes:       No:
 
Extracurricular and Personal Activities
Please list your extracurricular and community involvement.  Include specific accomplishments such as musical instruments played, student government committees, etc.  In the right column please check mark the activities you hope to pursue in college.  (Note: Athletics are requested in the section immediately following this section.)
 
Grade level or year of participation
    
Activity
9
10
11
12
PG
Positions held or honors won
Would you like to participate at Bethany?
Other achievements, awards, honors, special recognition:
 
Athletics
 
Please indicate V, JV, or I (Intramural) for level of participation
  
Would you like to participate at Bethany? 
Athletics
9
10
11
12
PG
Positions held or honors won
  
Baseball
Basketball
Cross Country
Cheerleading
Dance Team
Football
Golf
Soccer
Softball
Tennis
Track and Field
Volleyball
Other
 
How did you first become interested in Bethany?
Have you ever been on the Bethany Campus? Yes No If yes, for:
Is Bethany your first choice? Yes No If No, indicate choice level:
List 3 other colleges you applied to:
I hereby acknowledge that the information submitted is true and correct.  I grant the college permission to forward any pertinent information to authorized offices and agencies.  I agree to respect the traditions of Bethany College and abide by its regulations.

Bethany College does not discriminate on the basis of sex, abilities, age, race, religion, sexual orientation, national or ethnic origin, or veteran status in the recruitment and admission of students, the recruitment and employment of faculty and staff, and the operation of any of its educational programs and activities, as specified by federal laws and regulations.

By submitting this form, you are giving Bethany College permission to complete your addmissions process.

Please click once on the "Submit" button below to send your information electronically to the Bethany College Office of Admissions.  To clear the entire form, click once on the "Reset" button.

        


YOU WILL RECEIVE WRITTEN CONFIRMATION OF YOUR APPLICATION VIA U.S. MAIL WITHIN ONE WEEK.

If you do not receive written confirmation, please call 1-800-826-2281 for assistance.
Thank you for applying!

Bethany College
335 E. Swensson Street
Lindsborg, Kansas 67456-1897
Telephone: 1-785-227-3311 or 3380 x 8113
Admissions Fax: 1-785-227-8993
Admissions Telephone: 1-800-826-2281

 Copyright © 2006 Bethany College
Last Modified: April 22, 2008