Network Marketing Application

Your path to business ownership begins here! Fill out our free and easy application. Required fields are marked. Let us know if you need any assistance!

Tell us a little about yourself

* First Name:
Nickname:
* Middle Initial:
* Last Name:
* SSN:
* Email:
* Cell Phone:
Home Phone:
* Address:
* City:
* State:
* ZIP:
* Country:
* Gender:
* Birthdate: Month: Day: Year:
Marital Status:  Single Married Separated Divorced
If married, enter spouse's name:
What is your religious affiliation?

Educational Background

High School:
Graduation Year:
College:
Degree Earned:
Graduation Year:

U.S. Department of Education Demographic Information

The U.S. Department of Education has established new guidelines for collecting and reporting aggregated ethnic and racial data. In order to respond to this request, we ask you to answer the following questions.
Do you consider yourself to be Hispanic, Latino, or of Spanish origin?
 Yes No
In addition, please select one or more of the following racial categories to describe yourself.

When would you start classes at Bethany ?

* Desired Entry Date: Year:
 Fall Spring Summer

In what class or classes are you enrolling?

Terms of Application

I understand that if I become a degree-seeking student at Bethany College, I must go through the official application procedures in the Office of Admissions.

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.

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 rules and regulations.

By submitting this application and if I am accepted into the program, I will be responsible for payment for all charges that are incurred.

I understand and accept these terms.
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Tell us a little about yourself.

First Name *

Last Name *

SSN *

Email *

Phone *

Address *

City *

State *

Zip *

Country *

Gender

BirthDate *

Marital Status

Religious Affiliation


U.S. Department of Education Demographic Information

The U.S. Department of Education has established new guidelines for collecting and reporting aggregated ethnic and racial data. In order to respond to this request, we ask you to answer the following questions.

Please select one or more of the following racial categories to describe yourself.


When would you start classes at Bethany?

Desired Entry Date *

Entering As *

Select interests (multiple):


Where are you currently enrolled?

Current High School or College *

Above Graduation Year (if applicable)

GPA

ACT Score

SAT Score


Financial Aid

Do you intend to apply for financial aid?

Have you been convicted of a felony?


Questions or Comments?


Terms of Application

I understand that if I become a degree-seeking student at Bethany College, I must go through the official application procedures in the Office of Admissions.

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.

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 rules and regulations.

By submitting this application and if I am accepted into the program, I will be responsible for payment for all charges that are incurred.

I understand and accept these terms.


Please enter these characters below. captcha


Contact

Photo of Jenni Richardson , Ph.D.

Jenni Richardson, Ph.D.

Assistant Professor of Business Director of Online & Outreach EducationDepartment of Business
Social Science Center Phone: (620) 241-4720
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