College Admissions Form

Blue Mountain Christian University

201 W. Main St. Blue Mountain, MS, 38610

admissions@bmc.edu

www.bmc.edu

(662) 685-4771
Undergraduate admissions application

Enter your admission information below
Please verify that you are human*
Name*

First NameMiddle/Maiden NameLast Name
Preferred Name*
Gender*

MaleFemale
Birth Date*

MonthDayYear
Cell Phone Number*
Home Phone Number*
Please enter a valid phone number.
E-mail Address*
example@example.com
E-Mail Address*
Age:*
Mailing Address*

Address 1

Address 2

CityState / Province

Postal / Zip Code
County:
Emergency Contact*

First NameLast Name
Relationship*
Email*
example@example.com
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Do you speak any languages other than English?*

YesNo
Please list them

Agree and Submit:

Blue Mountain Christian University (BMCU) does not discriminate on the basis of race, color, national origin, sex (including pregnancy), age, disability, military service, or genetic information in its programs, activities, or employment. As a Christian institution, BMCU reserves the right to make decisions consistent with its mission and religious identity.

By clicking “I Agree” and submitting this application, I:
- Certify that the information provided is true and complete.
- Agree to abide by all University policies and standards of conduct.
- Give my express consent for BMCU to contact me using the personal email address(es) and phone number(s) I have provided (self-reported), including by email, phone, and text message.
- Authorize BMCU to send enrollment-related information — including admissions, financial aid, billing, and other education records — to those contact methods.
- Understand that messages may contain sensitive information, message and data rates may apply, and I may opt out of text messages at any time.
This consent remains in effect unless revoked in writing to The Office of Admissions at admissions@bmc.edu.
Agree & Submit:*

I agree to the wavier above
Should be Empty: