BGMU DUAL SCIENTIST APPLICATION

DUAL SCIENCE IS ONLY 800 HOURS
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What city and state do you live in?*
EX: Dallas, TX
Date of Birth*
EX: 11-16-2000
Referred From*
If referred from a BGMU Scientist, please tell us who
Level of Interest*
Program Type*
FYI: ENROLLMENT FEE MUST BE MADE TWO WEEKS PRIOR TO START DATE

First tuition payment is due the first day of class
Anticipated Start Date*
Why is now a great time for you to get your license?*
Should be Empty:

DUAL SCIENCE IS ONLY 800 HOURS