Office of Admission
 
Information Request Form
Contact Information
Title: Mr. Ms. Mrs.
First Name:
Middle Initial:
Last Name:
Contact Address Line 1:
( Optional ) Line 2:
City:
State:
( e.g. OH )
Zip:
( e.g. 44839 )
Contact Phone:
(e.g. 1-419-555-5555 )
Contact E-Mail:
( e.g. username@isp.net )

Education Information
High School Education
 
High School Attended:
 
 
Year Graduated:
( e.g. YYYY )
 
GED Information
  Do You Hold A GED? Yes: No:
  Date Received: ( e.g. MM/YYYYY )
 
Additional College / University
 
Other Schools You Have Attended.
 

Expected Enrollment / Programs of Interest
Expected semester of enrollment:
Fall: Spring: Summer: Year:  
 
Intended Major:
( Please select from the options below. )
One-Year Certificate Programs:
First Choice:  
Second Choice:  
 
Two-Year Associate Transfer Degree Programs:
First Choice:  
Second Choice:  
 
two-Year Associate Career & Technical DegreeS:
First Choice:  
Second Choice:  
 
Four-Year Bachelor Degree:  
First Choice:  
Second Choice:  
 
Masters Degree:
First Choice:  
Second Choice:  
   
Undecided:

 
Information You would Like Sent to you:
( Please Check All That Apply )
BGSU Firelands Application for Admission
BGSU Firelands Fact Sheet
Financial Aid / Scholarships Information Packet
Majors, Programs and Degree information
Additional Comments: