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Bridgewater State University

 

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Prospect Information Form

 

Information Please enter the requested information. Please note that an asterisk denotes required information.

Thank you for your interest in Bridgewater State University. We are pleased to offer over 30 undergraduate and over 30 graduate programs at the college as well as internships, study abroad and honors programs. Courses are also offered online, on weekends, in the summer and at several of our off-campus locations. Our focus is on preparing you for your future and we strive to provide the resources and academic standards you need to meet your personal and professional goals. We offer small, personal classes, professional development opportunities, on campus housing for undergraduates and our campus features a state of the art wireless network.

Required - indicates a required field.
Information Please enter your name in the section below. Please enter your complete first name, middle initial and last name. Please be sure to use upper and lower case. For example: John J. Smith, Jr. The suffix options are Jr., II, III, IV, Sr. or similar.

Prospect Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Mailing Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Prospect SSN/TIN/TFN
U.S. Social Security Number: (999999999 or 999-99-9999)

Prospect Birthdate
Date of Birth: Month Day Year (YYYY)

Prospect Citizenship
Citizenship:

Prospect Gender
Gender: Male Female Not Specified

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Prospect Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian or Alaska Native
Asian
Black or African American
Cape Verdean
Native Hawaiian or Other Pacific Islander
White

Prospect Entry Term
Term of Entry:Required

Prospect Major
Major:

Prospect High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

How Prospect Learned About Us
How I Learned About Bridgewater State University:



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