Alumni Referral Form

Do you know a prospective student who would be a perfect match for Belhaven University?  Just fill out as much information as possible about the student and our Admission office staff will make contact with him/her about the possibility of attending BU.  Thank you for helping spread the word about your alma mater and building future Blazers!

Student’s Information:
 
First Name:
Last Name:
Street Address:
Address Cont:
City:
State:
Zip:
Phone:
E-Mail:
Program of Interest: Traditional (18-22 year olds)
Online Program
Adult Evening Completion
Home School - High Scholar
Relation to Prospective Student:
Year of Graduation:
Additional Comments:

We would love to send you an appreciation gift for this referral. Please provide us with the following information.

Alumni Information:
 
First Name:
Last Name:
Class Year:
Street Address:
Address Cont:
City:
State:
Zip:
E-Mail:
Enter the numerical value of ten minus three.

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