Dual Enrollment Application

First Name

Preferred Name

Last Name

Birthdate

Gender

Citizenship

Contact Information

Personal Email Address
(Do not use a school email)

Mailing Address

Country

Street

City

Region

Postal Code

Cell Phone Number

Do you agree to receive recurring automated text messages from BMCU at the number provided.

Yes

No

School Information

School Name

Previous School Name

level (hidden)

Anticipated Graduation Year

Incoming Academic Information

Dual Enrollment Term

Have you previously been enrolled in Dual Credit Courses at BMCU?

Yes

No

Have you taken any other Dual Credit courses at other institutions?

Yes

No

Previous School Name

level (hidden)

Additional Information

Religious Affilliation

Church Name

Are you a member of this church?

Yes

No

Disclosures & Certifications

I attest that all information submitted on this application is my own work, factually true, and honestly presented

By participating in Dual Enrollment at Blue Mountain Christian University, I understand that I am taking college-level courses and that all grades, withdrawals, and academic records become part of my official college transcript. I understand that these records may affect future admission, transfer, scholarship, and financial aid eligibility. I agree to follow all University academic, conduct, technology, and financial policies, and I understand that I am responsible for communicating with instructors and meeting all course expectations. I also understand that my college education records are protected under FERPA and that I, as the enrolled student, hold the associated privacy rights.

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Date