Apply Your Birchwood University Journey Starts Here 1 Step 1 PERSONAL INFORMATION NameNameaccount_circle e853 Birchwood University is allowed by law to request and use the Social Security Number according to federal and state guidelines. While you are not required to provide your Social Security Number, you are encouraged to do so. Your SSN is required for financial aid, educational tax benefits, and possible other purposes. This information may be disclosed only under certain circumstances. Date of Birthof appointmentdate_range Name on Transcript (if different from legal name)your full name EmailEmailemail CountryFullNamepick one!Select CountryAfghanistanAlbaniaAlgeriaAmerican SamoaArgentinaAustraliaAustriaBahamasBahrainBangladeshBarbadosBelarusBelgiumBhutanBrazilBulgariaCambodiaCanadaChileChinaColombiaCroatiaCubaCyprusCzech RepublicDenmarkEcuadorEgyptEl SalvadorEstoniaEthiopiaFijiFinlandFranceGeorgiaGermanyGhanaGreeceGuyanaHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsraelItalyJamaicaJapanJordanKazakstanKenyaKuwaitLatviaMalaysiaMaldivesMaltaMexicoMongoliaMoroccoMyanmarNamibiaNauruNepalNetherlandsNew ZealandNigeriaNorwayOmanPakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarSaint LuciaSaudi ArabiaSingaporeSouth AfricaSpainSri LankaSudanSwedenSwitzerlandTaiwan, Province Of ChinaTajikistanTanzania, United Republic OfThailandTrinidad And TobagoTunisiaTurkeyTurkmenistanUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamWallis And FutunaZambiaZimbabwe ISDISD MobileMobilecall Current Mailing Addressyour full name Home Phoneyour full name Cityyour full name Stateyour full name Countryyour full name Zip Codeyour full name Cell Phoneyour full name Permanent Addressyour full name Home Phoneyour full name Cityyour full name Stateyour full name Countryyour full name Zip Codeyour full name Cell Phoneyour full name Emergency Contact: Nameyour full name Home Phoneyour full name Emaila valid emailemail Work Phoneyour full name Birchwood University is required to report gender and race/ethnicity information to certain federal and state agencies as this data relates to civil rights compliance. Are you hispanic?YesNo GenderMaleFemale What is your race? (Choose one or more)American Indian Alaska NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderWhiteOther Are you currently active duty, a veteran, a member of the National Guard, or a Reservist in the United States Armed Forces?YesNo ENROLLMENT INFORMATION pick one!Applying For - Select Program ▽Master of Business AdministrationMaster of Science in Data ScienceMaster of Science in Cyber Security Semester you plan to attend:SpringFallSummer I plan on attending:Full-TimePart-Time Last College Attended College Nameyour full name City/Stateyour full name Year Attended (From-To)your full name Degree Earnedyour full name Have you applied to this institution before?your full name Have you ever attended this institution before?your full name Submit The Details keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder Should you have any questions or issues during the application process, please send us an email at info@birchwoodu.org
