*I'll attend this day. (Choose one.)

Saturday, April 24 - Enrollment Day

Friday, June 4 - Enrollment Day

Saturday, June 26 - Enrollment Day

Friday, July 9 - Enrollment Day

Saturday, August 7 - Enrollment Day

*First Name:     Middle Initial:     *Last Name:       * Gender Female Male

*Address:
*City:    *State: Select a State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY    *Zip:
*Country:
  
* Home Phone:
Cell/Alternate Phone:

*E-Mail:

*Your Academic Major...
   Choice 1) Still Deciding Art / Ceramics Art / Drawing Art / Painting Art / Sculpture Art Teaching PreK-12 / Ceramics Art Teaching PreK-12 / Drawing Art Teaching PreK-12 / Painting Art Teaching PreK-12 / Sculpture Art Therapy Pre-Professional Major Visual Art Administration Major Athletic Training Biology Biology Teaching 6-12 Business Education Teaching 6-12 Chemistry Chemistry Teaching 6-12 Christian Ministries / Christian Education Christian Ministries / Pre-Seminary Christian Ministries / Sacred Music Christian Ministries / Social Justice and Service Christian Ministries / Youth Ministry Communication Criminal Justice Economics-Business / General Economics-Business / Accounting Economics-Business / Business Mgt Economics-Business / Economics Economics-Business / Finance Economics-Business / International Mgt Economics-Business / Marketing Elementary Education Teaching K-6 Elementary Education Non-Teaching English English Teaching 6-12 Health & Physical Education Teaching PreK-12 History-Political Science Mathematics Mathematics Teaching 6-12 Mathematics 3+2 Engineering Music / Instrumental Music / Keyboard Music / Vocal Music Teaching PreK-12 / Instrumental Music Teaching PreK-12 / Vocal Physics Contract Major Psychology Social Science Teaching 6-12 Social Work Sports Management Theatre / Communication Major
   Choice 2) Still Deciding Art / Ceramics Art / Drawing Art / Painting Art / Sculpture Art Teaching PreK-12 / Ceramics Art Teaching PreK-12 / Drawing Art Teaching PreK-12 / Painting Art Teaching PreK-12 / Sculpture Art Therapy Pre-Professional Major Visual Art Administration Major Athletic Training Biology Biology Teaching 6-12 Business Education Teaching 6-12 Chemistry Chemistry Teaching 6-12 Christian Ministries / Christian Education Christian Ministries / Pre-Seminary Christian Ministries / Sacred Music Christian Ministries / Social Justice and Service Christian Ministries / Youth Ministry Communication Criminal Justice Economics-Business / General Economics-Business / Accounting Economics-Business / Business Mgt Economics-Business / Economics Economics-Business / Finance Economics-Business / International Mgt Economics-Business / Marketing Elementary Education Teaching K-6 Elementary Education Non-Teaching English English Teaching 6-12 Health & Physical Education Teaching PreK-12 History-Political Science Mathematics Mathematics Teaching 6-12 Mathematics 3+2 Engineering Music / Instrumental Music / Keyboard Music / Vocal Music Teaching PreK-12 / Instrumental Music Teaching PreK-12 / Vocal Physics Contract Major Psychology Social Science Teaching 6-12 Social Work Sports Management Theatre / Communication Major
   Choice 3) Still Deciding Art / Ceramics Art / Drawing Art / Painting Art / Sculpture Art Teaching PreK-12 / Ceramics Art Teaching PreK-12 / Drawing Art Teaching PreK-12 / Painting Art Teaching PreK-12 / Sculpture Art Therapy Pre-Professional Major Visual Art Administration Major Athletic Training Biology Biology Teaching 6-12 Business Education Teaching 6-12 Chemistry Chemistry Teaching 6-12 Christian Ministries / Christian Education Christian Ministries / Pre-Seminary Christian Ministries / Sacred Music Christian Ministries / Social Justice and Service Christian Ministries / Youth Ministry Communication Criminal Justice Economics-Business / General Economics-Business / Accounting Economics-Business / Business Mgt Economics-Business / Economics Economics-Business / Finance Economics-Business / International Mgt Economics-Business / Marketing Elementary Education Teaching K-6 Elementary Education Non-Teaching English English Teaching 6-12 Health & Physical Education Teaching PreK-12 History-Political Science Mathematics Mathematics Teaching 6-12 Mathematics 3+2 Engineering Music / Instrumental Music / Keyboard Music / Vocal Music Teaching PreK-12 / Instrumental Music Teaching PreK-12 / Vocal Physics Contract Major Psychology Social Science Teaching 6-12 Social Work Sports Management Theatre / Communication Major

Proposed Activities: (Music, Sports, Etc.)
1) 2) 3)

* High School/College:   *H.S. Grad Year

*GPA:              *ACT / SAT Composite Score:           *Class Rank:

Number of guests:

Please press the submit button only once when completed. If you press the clear button all information will be cleared or lost and you may restart.

If you have suggestions on how we may better serve you as a prospective Bethany student please e-mail the Admissions Office at: admissions@bethanylb.edu.