BHSU: Returning Student Application
Student Contact Information
First Name (full, legal)
Middle Name
Last Name
Preferred First Name
Former/Maiden Last Name(s)
BHSU Student ID/Buzz Card Number
Date of Birth
Email
Phone/Mobile
Permanent Mailing Address
Permanent Mailing City
Permanent Mailing State
Permanent Mailing Zip/Postal Code
Emergency Contact Information
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone
Emergency Contact Email
Relationship to You
Please select...
Parent
Legal Guardian
Spouse
Other/not listed
Academic & Residency Information
Have you lived in South Dakota for the past 12 months?
Yes
No
If you are a South Dakota resident, but you have not lived in South Dakota for the past 12 months, please explain.
When/Where did you last take classes from a South Dakota public university?
Semester and year you wish to re-enroll:
Summer 2024
Fall 2024
Spring 2025
Which campus/location do you plan to take most of your classes:
Spearfish campus
Rapid City campus (university center)
Internet/Online
Ellsworth AFB
Will you be pursuing a degree?
Yes
No
Will you be an Undergraduate (Associate's or Bachelor's degree) or Graduate (Master's degree) level student?
Undergraduate
Graduate
What degree/major will you be pursuing?
If you wish to register for a
specific
BHSU course or section, please list it here.
Have you attended any other post-secondary institutions after you discontinued enrollment at BHSU, regardless of length of attendance and even if no work was completed?
No
Yes
Please list Name of institutions attended, along with start and end dates of attendance:
Certification of Accuracy
All answers I have given on this form are complete and accurate to the best of my knowledge. I understand that a readmission decision will be based on the information provided herein and other relevant academic and administrative information.
I agree
Signature (type your full, Legal Name, in the box below).
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