Personal Information |
Last (Family) Surname:
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First (Given) Name:
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Middle Initial:
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Country of Citizenship:
Is your native language English?
Yes
No |
Date of Birth MM/DD/YYYY
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Gender
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Marital Status
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Country of birth
City of birth
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Full Home Address (Include city, state, province and zip code, if any)
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Name of Parent(s) or Guardian(s)
Address (If different from yours)
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Your Country of Permanent Residence
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Your Email:
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Social Security Number
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Home Phone Number (Include country code)
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Work Phone Number
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Mobile Phone Number
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Do you have a U.S. Visa?
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If yes, what type?
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When does this visa expire?
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Have you ever been convicted of a crime?
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If yes, please attach a statement of explanation
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Are you a U.S. permanent Resident?
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If yes, alien registration Number:
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Applying for:
August 20
January 20 |
Summer I 20
Summer II |
Application Status:
Freshman
Transfer
Transient
Continuing Ed.
Non-Degree Seeking |
Housing preference:
On campus
Off Campus |
*Race or Ethnic Origin:
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Religious Denomination:
*This information is voluntary and is not used as a factor in the admssion decision nor is it used in a discriminatory manner. |
Please tell us the highest educational level completed by: Your Father
Your Mother
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How did you hear about Benedict College?
College Recruiter
Relative/friend attended BC
Poster/flyers
Magazine
High School Counselor
Television
Benedict Graduate
Radio
Other (please specify)
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List Extracurricular Activities: Sports
Clubs:
Organiztions:
Other:
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Intended Major (Please Select)
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U.S. Address (if you have one)
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Emergency Contact Information: Name of parent, guardian or other person to be notified in case of emergency |
Name: Last (famly Name or Surname)
First (Given Name):
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Relationship to Applicant:
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Address (if different from yours)
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Country of Permanent Residence:
Email Address:
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Phone Numbers (include Country Code) Home:
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Mobile:
Work:
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English Testing Information: Benedict College requires all applicants whose native language is not English to demonstrate English language proficiency by showing one of the following (please check one): Proof of having taken at least one year of English language instruction from a reputable English teaching institution
or, 2); proof of having taken the Test of English as a Foreign Language (TOEFL)
, the SAT
ACT
IELTS
Other(please specify)
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Name of Institution:
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Dates Attended:
From:
To: |
Certificate Obtained
___Yes
___No |
Contact Information
Name:
Address:
Phone number:
Fax:
Email:
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Test |
Date Test Taken |
Score(s) Please list, Math, Verbal, if applicable |
TOEFL |
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SAT |
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ACT |
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Other |
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Please list all educational institutions attended. Begin with high school and include any school you are presently attending. |
Name of Institution |
City/Country |
Dates of Attendance |
Year of Graduation |
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