Request More Information
Please select a program:
*
Jackson - Traditional Undergraduate Admission (including international students)
Jackson - Adult and Graduate Programs
Online
Atlanta Campus for Adult Education
Chattanooga Campus for Adult Education
Dalton Campus for Adult Education
Houston Campus for Adult Education
Memphis Campus for Adult Education
Orlando Campus for Adult Education
First Name:
*
Last Name:
*
Street Address:
*
Address (cont.)
City:
*
State:
*
Zip Code:
*
Country:
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antilles Netherlands
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caymen Islands
Central Africa Republic
Chad
Chile
China
Christmas Island
Cocos Islands (Keeling)
Columbia
Comoros
Cong Brazzaville
Congo Kinshasa
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard McDonald
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
N. Mariana Islands
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
S. Georgia and S. Sandwich Island
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanke
St Kitts and Nevis
St. Helena
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Island
Swaziland
Sweden
Switzerlan
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
US Minor
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands British
Virgin Islands US
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
*
Home Phone:
*
Cell Phone:
Email Address:
How did you hear
about Belhaven?
Country of Citizenship:
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antilles Netherlands
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caymen Islands
Central Africa Republic
Chad
Chile
China
Christmas Island
Cocos Islands (Keeling)
Columbia
Comoros
Cong Brazzaville
Congo Kinshasa
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard McDonald
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
N. Mariana Islands
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
S. Georgia and S. Sandwich Island
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanke
St Kitts and Nevis
St. Helena
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Island
Swaziland
Sweden
Switzerlan
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
US Minor
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands British
Virgin Islands US
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
*
High School Attended:
*
High School Graduation Date:
*
mm/dd/yyyy
Colleges Attended:
ACT Score:
SAT Critical Reading Score:
SAT Math Score:
GPA:
Academic Interest:
Undecided
Accounting
Accounting Certificate
Art
Arts Administration
Biblical Studies & Ministries - Biblical Studies Concentration
Biblical Studies & Ministries - Cultural Relations Concentration
Biblical Studies & Ministries - Family Studies Concentration
Biblical Studies & Ministries - Leadership Concentration
Biblical Studies & Ministries - Pre-Seminary Concentration
Biblical Studies & Ministry - Youth/Child Study Concentration
Biblical Studies and Ministries Certificate
Bilogical Sciences - Ecological Sciences Concentration
Biological Sciences
Biological Sciences - Cellular/Molecular Concentration
Biological Sciences - Human Physiology Concentration
Business Administration
Business Administration - Entrepreneurship Concentration
Business Administration Certificate
Chemistry
Chemistry - Biochemistry Concentration
Chemistry - Chemical Physics Concentration
Classical Education Studies
Communication - Electronic Communication Concentration
Communication - Journalism Concentration
Communication - Public Relations Concentration
Communication - Sports Broadcasting Concentration
Creative Writing
Dance
Dance Apprentice
Dance Certificate
Elementary Education
English
Family Studies Certificate
Graphic Design
History
Intercultural Studies
International Studies
Mathematics
Music - Collaborative Piano and Pedagogy Concentration
Music - Composition Concentration
Music - Music Ministries Concentration
Music - Musical Theatre Concentration
Music - Performance Concentration
Music - Vocal Pedagogy & Choral Conducting Concentration
Music Education
Philosophy of Worldviews
Political Science
Psychology
Social Work
Sports Administration
Sports Administration - Coaching Concentration
Sports Medicine: Exercise Science
Sports Ministry
Theatre - Acting Concentration
Theatre - Dramatic Writing Concentration
Theatre - General Emphasis Concentration
Theatre - Hisory & Literature Concentration
Theatre - Ministry Concentration
Theatre - Musical Theatre Concentration
Theatre - Production & Design Concentration
*
Extracurricular Activities / Sports:
Arts
----------------------------------------
Art
Dance
Marching Band
Choir
Instrumental Ensemble
Jazz Band
Orchestra
Theatre
Wind Symphony
----------------------------------------
Athletics
----------------------------------------
Baseball
Basketball - Men's
Basketball - Women's
Cheerleading
Cross Country - Men's
Cross Country - Women's
Football
Golf
Soccer - Men's
Soccer - Women's
Softball - Women's
Tennis - Men's
Tennis - Women's
Volleyball - Women's
----------------------------------------
Intramural Sports
Publications
Religious Organizations
Student Government
Select the degree you are interested in:
Associate of Arts
Bachelor of Arts in Social Services
Bachelor of Business Administration
Bachelor of Science in Management
Bachelor of Health Administration
Master of Business Administration
Master of Science in Leadership
Master of Arts in Teaching - Elementary
Master of Arts in Teaching - Secondary
Master of Education in Education - Elementary
Master of Education in Education - Secondary
PACE - Bachelor of Education
Master of Public Administration
Work Phone:
Intended Date of Entry:
*
Any additional comments?
Undergraduate Degree:
Intended Month of Entry:
January
March
June
July
August
October
*
Are you licensed to teach in Mississippi?
Yes
No
Are you licensed to teach in any other state?
Yes
No
Any additional comments?
Intended Month of Entry:
January
March
June
July
August
October
*
How many credit hours do you currently have?
Are you currently employed as a teachers assistant?
Yes
No
Intended Date of Entry:
Fall
Summer
Spring
*
Programs of Interest:
Associate of Arts
Associate of Arts in Business
Bachelor of Science in Management
Bachelor of Business Administration
Bachelor of Health Administration
Master of Business Administration
Master of Education - Elementary Education Concentration
Master of Education - Secondary Education Concentration
Master of Education in Reading Literacy
Master of Health Administration
Master of Public Administration
Master of Science in Leadership
Master of Sports Administration
High Scholars
High Scholars Dual Enrollment
*
Intended Month of Entry:
January
March
May
June
July
August
October
*
Work Phone:
Intended Date of Entry:
*
What degree are you interested in?
Bachelor of Health Administration
Bachelor of Arts in Social Services
Bachelor of Science in Management
Master of Business Administration
*
Any additional comments?
Work Phone:
Intended Date of Entry:
*
What degree are you interested in?
Associate of Arts
Bachelor of Health Administration
Bachelor of Arts in Social Services
Bachelor of Science in Management
Master of Business Administration
Master of Science in Leadership
*
Any additional comments?
Work Phone:
Intended Date of Entry:
*
What degree are you interested in?
Bachelor of Health Administration
Bachelor of Arts in Social Services
Bachelor of Science in Organizational Management
Master of Business Administration
*
Any additional comments?
Work Phone:
Intended Date of Entry
*
What degree are you interested in?
Associate of Arts
Bachelor of Business Administration
Bachelor of Health Administration
Bachelor of Science in Management
Master of Business Administration
Master of Education
Master of Science in Leadership
*
Any additional comments?
Work Phone:
Intended Date of Entry:
*
What degree are you interested in?
Associate of Arts
Bachelor of Business Administration
Bachelor of Health Administration
Bachelor of Arts in Social Services
Bachelor of Science in Management
Master of Business Administration
Master of Arts in Teaching
Master of Education
Master of Science in Leadership
*
Any additional comments?
Work Phone:
Intended Date of Entry:
*
What degree are you interested in?
Associate of Arts
Associate of Arts in Biblical Studies
Associate of Arts in Christian Ministry
Bachelor of Arts in Biblical Ministries
Bachelor of Arts in Social Services
Bachelor of Business Administration
Bachelor of Science in Management
Certificate in Biblical Studies and Ministries
Master of Business Administration
Master of Science in Leadership
Master of Arts in Teaching
Master of Education
*
Any additional comments?
Enter the numerical value of ten minus three.
*
* Indicates Required Field
Site Map
|
Search
FUTURE STUDENTS
Undergraduate Studies
Adult & Graduate Studies
Online Studies
Academics
Admission
Financial Aid
Athletics
ABOUT
Profile
Mission
Social Media
News & Events
Calendar
Virtual Tour
Employment
ALUMNI/FRIENDS
Homecoming
Online Directory
Giving to Belhaven
Church Relations
Bookstore
CURRENT STUDENTS
BlazeNet
Cybergate
Check E-Mail
Campus Life
Library
Registrar
Adult Student Services
Parent Resources
CONTACT
Atlanta
Chattanooga
Houston
Jackson
Memphis
Online
Orlando
FUTURE STUDENTS
::adCenter::
