College Application

Process Section application :

Application For Enrollment


First Name:
Middle Name:
Last Name:
Address #1:
Address Line #2:
City:
State:
Zip
Home Phone:
Day Phone:
Cell Phone:
E-Mail Address:
Emergency Contact:

Date of Birth:
Gender:
Marital Status:
Country of Citizenship:
Primary Language:
Academic Section:
High School Last Attended:
City\State:
Date of Graduation:
Date GED was earned:
Facility GED was Earned:
College Attended:
Dates Attended:
Major:
Degree:
College Attended:
Date Attended:
Major:
Degree:
ACADEMIC INTENTION SECTION
Semester you plan to start BCI:
Do you plan to attend::
Choose time that would work for you:
Which program are you applying for:

FINANCIAL SECTION:
All applicants accepted to BCI have the opportunity to apply for Financial Aid. Do you wish to take part in any of these programs?:
APPLICATION PROCESS SECTION
Submit a copy of the following::
1) High School Diploma of GED:
2) Provide a photo copy of your ID:
3) HIgh School or College Transcripts:
4) Documented physical exam from within the last 6 months.:
Return this application with a $30.00 Non refundable fee and the above information to:
Bio-Chi Institute 1925 Geneva Street Sioux City, Iowa 51103 (712)252-1157
I affirm that the information submitted is complete and correct, and understand that to provide false information could result in my immediate dismissal. I agree to follow and respect all of Bio-Chi Institute's policies and procedures.:
Signature of applicant________________________________ Date____________________ (If submitted in electronic format signature will be obtained during tour of facillity)

College Application

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