Student Agreement Request


To ensure the timely processing of your form, please enter all of the necessary information.

1. The following information is needed by academic advisors at Bismarck State College to complete the Student Agreement.:
* Student's Name:

* Last 4 digits of SSN:

* Branch of Service:

* Pay Grade:

* MOS or Rating:

* Military Installation:

* Desired Degree:

2. Provide the names of the other college(s)/universities you have previously attended Send your transcripts to: Bismarck State College, Attn: Admissions, PO Box 5587, Bismarck, ND 58506.:

3. List any CLEP/DANTES, DSST, etc, that you wish to have evaluated toward your degree:

4. I understand that by requesting a Student Agreement, I authorize Bismarck State College to provide copies of the Agreement and academic progress reports to the appropriate US military voluntary education offices.
* Day Phone:

Evening Phone (if different from day):

* Email:

* Signature: I certify to the best of my knowledge that the information on this form is true and complete without evasion or misrepresentation:
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