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BSC/CWA Academic Information Request
Welcome CWA Members to Bismarck State College!
We are glad you're interested in how Bismarck State College can help you reach beyond to the life you imagine. BSC's online offerings include courses that lead to a Program Certificate or an Associate in Applied Science degree.
Please answer the following questions to help us customize your experience with BSC.
*Indicates Required Field.
To ensure the timely processing of your form, please enter all of the necessary information.
* First Name:
Middle Initial:
* Last Name:
* Address Line 1:
Address Line 2:
* City:
* State:
* Country:
* Zip Code:
* Date of Birth (00/00/0000):
* Preferred Phone Type:
select one...
Cell
Home
Parent
Work
* Phone Number (area code):
* Email:
* Confirm Email Address:
Gender:
select one...
Male
Female
Ethnicity:
select one...
Hispanic/Non-white
American Indian/Alaska Native
Asian
Black/African-American
Native Hawaiian/Other Pacific Island
White
* Academic Interest
Use control key to select more than one answer
:
Webpage Development & Design
Information Processing Specialist
Computer Support Specialist
Electric Transmission Systems Technology
Nuclear Power Technology
Petroleum Production Technology
Power Plant Technology
Process Plant Technology
* When would you be interested in starting? (Term)
:
Fall
Spring
Summer
Name of Employer:
Job Title:
Union Affiliate:
Local Number:
Do you have any questions or comments:
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