Alumni Services

Bethel College Prospective Student Referral Form

Thank you for recommending a student you think would benefit from attending Bethel College. The fields marked with an asterisk (*) are required.

Let us know who you are

*First name:	*Last name:	Middle name:
Did you attend Bethel College? yes no	If so, what year(s)?

Contact information (in case we have questions)

Prospective Student Information

*Enrollment Type:

Gender:
Male Female

Expected Term*:

*Year:

Prospective Student's Name

*First name:	*Last name:	Middle name:
Preferred name (if different from first name):

Address

Street or P.O.Box*:
*City:	*State:	*ZIP:

Telephone/e-mail

*Home phone:

Cell phone:

*E-mail:

Academic information

*High school:

*Year of graduation:

Transfer Students Only:

College/University attending/attended:

Dates Attending/Attended: