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Request For More Information

Thank you for your interest in Bethel University. By completing this form, you will create a new request for more information about our programs.
Please note, an asterisk (*) denotes a required question.



Ready to Apply?

Student Information

Full Name *
Preferred Name *
Date of Birth *
Mailing Address
Mailing Address (continued)
City
State
Zip/Postal Code
Phone Number *
Cell Phone Number
Email *
Verify Email *
High School Attending
County of School *
Anticipated Graduation Year

Parent Information

Full Name *
Mailing Address *  
Mailing Address (continued)
City *
State *
Zip/Postal Code *
Home Phone Number *
Cell Phone Number
Work Phone Number
Email *
Verify Email *

Enrollment Information

When do you plan to enter Bethel's dual enrollment program?
List course(s) of interest:

Personal Information

Full Name *
Position Held *
Name of High School *
School System *
County of School *
Physical Address of High School *
Physical Address (continued)
City *
State *
Zip/Postal Code *
Mailing Address of High School *
Mailing Address (continued)
City *
State *
Zip/Postal Code *
Email *
Verify Email *
Contact Phone Number*
List course(s) of interest:

Personal Information

Full Name *
Name of High School
School System
County of School
Physical Address of High School
Physical Address (continued)
City
State
Zip/Postal Code
Mailing Address of High School
Mailing Address (continued)
City
State
Zip/Postal Code
Email *
Verify Email *
Contact Phone Number *
Personal Phone Number *
I would be interested in teaching (check all that apply): *
  

Qualifications

Resumé Upload
List subjects qualified to teach at college level: