Belmont University

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Personal Information

First Name*

Preferred First Name

Middle NameEnter Given Middle Name, Not Initial

Enter Given Middle Name, Not Initial

Last Name*

Email Address*

Confirm Email Address*

Cell Phonexxx-xxx-xxxx

xxx-xxx-xxxx

Home Phonexxx-xxx-xxxx

xxx-xxx-xxxx

Check if address is outside of U.S. or Canada

Address *

City

State/Province*

ZIP/Postal Code*

Country*

Foreign Postal Code*If No Postal Code, Please Enter 00000

If No Postal Code, Please Enter 00000

Citizenship Status*

Birth Date

Have you served in the military?

Gender

Are you Hispanic or Latino?

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member.

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Academic Information

Are you transferring to Belmont?

High School 1

Are you a Home Schooled Student?

High School *If not home schooled, enter your high school here. To do so, follow these steps:
Enter Organization Name (full or partial) or select both Country and State. Then click on the Search button below City.

If not home schooled, enter your high school here. To do so, follow these steps:
Enter Organization Name (full or partial) or select both Country and State. Then click on the Search button below City.

Organization Name (full or partial)

Country

State/Province

City (full or partial)

Unlisted School Name and AddressIf you cannot find your high school, or you were home schooled, please enter the school name and address below. Otherwise, leave this area blank.

If you cannot find your high school, or you were home schooled, please enter the school name and address below. Otherwise, leave this area blank.

Graduation DateIf you don't know your exact graduation date, please enter 6/1/[The year that you graduated]. Example 6/1/2014

If you don't know your exact graduation date, please enter 6/1/[The year that you graduated]. Example 6/1/2014

College(s) Attended 1

College/University *Enter your College/University here. To do so, follow these steps:
Enter Organization Name (full or partial) or select both Country and State. Then click on the Search button below City.

Enter your College/University here. To do so, follow these steps:
Enter Organization Name (full or partial) or select both Country and State. Then click on the Search button below City.

Organization Name (full or partial)

Country

State/Province

City (full or partial)

Unlisted School Name and Address

Attended From Month

Attended From Year

Attended To Month

Attended To Year

Graduated

Degree Type

Degree Date

Degree Earned or Expected

+ Add College(s) Attended

Enrollment Information

Admission Type:*

Student Type:*

Intended Major*

Desired Entry Term:*

What year will you or did you graduate High School?*

Account Information

Password
Your password must contain at least 6 characters/digits*

Confirm Password
Your password must contain at least 6 characters/digits*

Password Question*If you forget your password, we will ask you this question in order to reset it.

If you forget your password, we will ask you this question in order to reset it.

Password Answer*If you forget your password, you must provide this answer in order to reset it.

If you forget your password, you must provide this answer in order to reset it.

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