Bethel College Request Information Form

General Information

Enrollment Type*:

Gender:
Male Female

Expected Term*:

Year*:

Name

First name*:

Last name*:

Preferred first name:

Postal Address

Telephone/e-mail

Home phone*:	Cell phone:	E-mail*:
Citizenship*:

Academic information

Transfer Students Only:

College/University attending/attended:

City, State/Province:

Dates Attending/Attended:

Academic interests:

Extracurricular/athletic interests:

Additional information

Please describe your interest level in Bethel College:
Very interested Somewhat interested Uncertain

Would you consider visiting Bethel College?
Yes No

Do you plan on applying to Bethel College?
Yes No

How did you learn about Bethel College?*

How important are the following issues in your college search?

	Very	Somewhat	Not Important	Don't Know
Offering your major
College reputation
Extracurricular options
Cost
Scholarships and financial aid

Request Information