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!

Your information:
First Name:
Last Name:
Year(s) Attended Belhaven:
 
Student's information:
Your relationship to student:
First Name:
Last Name:
Street Address:
Address Cont:
City:
State:
Zip:
Phone:
E-Mail:
   
Expected Date of Entrance:
Year of Graduation:
Proposed Major:
   
Sports/Activities:
Make multiple selections by holding ctrl key and clicking on selection.
   
Other:
Additional Comments:

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Belhaven University