BU-X Student Approval for Admission

Student's First Name

Student's Last Name

Student's Email Address

Student's Cell Phone

Student's Birthdate

Student's Gender

Female

Male

Student's Age
Reminder: The majority of BU-X students should be between 17 and 25

BU-X Site

Intended Major

Intended start date

Student Type

Student SubType

Has this student been accepted into your BU-X program at your location?

Yes

No

Your Name

Your email address

Today's Date

Notes