application for admission
admission information
Applications are processed throughout the year and will continue to be received until the freshman class is filled.
An online application is available at: www.bsc.edu/admission/apply.cfm
Submit all materials to: Office of Admission
Birmingham-Southern College
900 Arkadelphia Road
Box 549008
Birmingham, AL 35254
APPLICATION
Candidates for admission must submit:
• thecompletedApplicationforAdmission,with$40applicationfee;
• thecompletedtypedpersonalstatement;
• anofcialcopyofhighschooland/orcollegetranscript(s);
• anofcialcopyofACTorSATscores;
• arecommendationletterfromaschoolcounselorandtheattachedschool
recommendation form.
Please attach a
recent wallet-size photo
of yourself here
with a paper clip and
print your name
and the date
on the back.
PERSONAL DATA
Name _____________________________________________________________________________________________________________
Last First Middle/Maiden PreferredName
StartTerm: StartYear: Classication: Category:
q Fall qExploration 20______ Freshman_____________ FirstYear_______________
q Spring qSummer Sophomore____________ Transfer________________
Junior_________________ Transient_______________
Senior ________________ Special Student __________
2nd Degree ______________
Home Address ______________________________________________________________________________________________________
Number, Street, or P.O. Box City State
__________________________________________________________________________________________________________________
ZIP County
Present Mailing Address _______________________________________________________________________________________________
(ifdifferentfromabove) Number,Street,orP.O.Box City State ZIP
HomeTelephone____________________________________________Student’sCellPhone________________________________________
Date of Birth __________________________________________________________________________________ q Male q Female
Month Day Year
Birthplace __________________________________________________ E-Mail Address ____________________________________________
City State
SocialSecurityNumber________________________________________Parent’sE-MailAddress_____________________________________
Religious Preference ___________________________________________________________________________ Veteran qYesq No
Marital Status q Single q Married q Divorced q Widowed
U.S. Citizen q International Student q Country of Citizenship __________________________________________________
PredominantEthnicOrigin(RequiredascompliancewithCivilRightsAct)
American Indian or Native American q Black, Non-Hispanic q Non-Resident alien q
Asian or Pacific Islander q Hispanic/Latinoq White, Non-Hispanic q
PermanentResident(thesestudentshavegreencards)q Other,(pleasespeciy)q ______________________
ACADEMIC DATA
HighSchoolAttended_____________________________________________________________________HighSchoolGraduationYear________
High School Address ___________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP County
TypeofSchool q Public q Private
All colleges or universities you have attended Dates Enrolled GPA
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Haveyoueverbeenunderacademicdiscipline,orsocialdisciplineand/orbeensuspendedorexpelled?
qYesq No If yes, please explain. ____________________________________________________________________________________
__________________________________________________________________________________________________________________
ACADEMIC AREAS OF INTEREST
Expected Major Interest ___________________________________________________________________________ Check here if undecided q
Expected Career Interest ___________________________________________________________________________ Check here if undecided q
TEST SCORE DATA
Ihavetaken ACTq SATq
Iplantotake ACTq SATq Date(s):______________________________________________________________________
PLEASELISTYOURSCORES: SAT-CR___________SAT-M___________SAT-W___________COMBINED___________
 ACTEH_______ ACTMA_______ACTREAD._______ACTSCI.REAS._______COMPOSITE___________
CAMPUS LIVING
Willyourequirecampushousing? qYes q No
COLLEGE DATA
List other colleges or universities to which you are applying _______________________________________________________________________
__________________________________________________________________________________________________________________
Ifyouarenotcurrentlyattendingschool,howhaveyouspentyourtimesinceyouwerelastastudent?_______________________________________
__________________________________________________________________________________________________________________
HowdidyourstbecomeinterestedinBirmingham-SouthernCollege?______________________________________________________________
List names of Birmingham-Southern students you know _________________________________________________________________________
HONORS PROGRAM*
FRESHMAN APPLICANTS:DoyouwishtobeconsideredfortheHonorsProgramCurriculum?qYesq No
*Minimumrequirements28ACT/1240SATand3.0GPA.
DoyouplantoparticipateintheFine&PerformingArtsCompetition?qYesq No
FINANCIAL AID DATA
Willyouapplyforneed-basedaidfromstateand/orfederalsources?qYesq No q Not Certain
(Reservationformsareonlineatwww.bsc.edu.DeadlineforsubmissionofreservationsisJanuary1.)
Doyouparticipateinastatepre-paidcollegetuition(PACT)plan?qYesq No
FAMILY DATA
Father _____________________________________________________________________________________________________________
Name
Home Address ______________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP
qAddresssameasstudent’s.
Mother ____________________________________________________________________________________________________________
Name
Home Address ______________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP
qAddresssameasstudent’s.
Step-Parent q or Guardian q ________________________________________________________________________________________
Name
Home Address ______________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP
qAddresssameasstudent’s.
Haveanyofyourparents,step-parents,orguardianseverearnedacollegiatebachelor’sdegreeorhigher?qYesq No
Parent to whom college information should be mailed _________________________________________________________________________
Please give names and relationships of relatives who have attended Birmingham-Southern.
__________________________________________________________________________________________________________________
Name Relationship Dates of Attendance
__________________________________________________________________________________________________________________
Name Relationship Dates of Attendance
Please give names and grade levels of all school-age siblings.
__________________________________________________________________________________________________________________
Name Grade in School
__________________________________________________________________________________________________________________
Name Grade in School
HONORS & ACTIVITIES
Name _____________________________________________________________________________________________________________
Last  First  Middle/Maiden PreferredName
High School ________________________________________________________________________________________________________
ACADEMIC HONORS
Brieydescribeanyscholasticdistinctionsorhonorsyouhaveachievedingrades9-12orattacharesume.
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
EXTRACURRICULAR ACTIVITIES
Please list your extracurricular, community, religious, and individual activities, as well as any work experience. Attach additional sheets
if necessary.
Do you plan to participate in intercollegiate athletics? qYesqNoWhichsport?____________________________________________
Approximate Will you
TimeSpentPositionsheldor  participate
Activity  Hrs./Week honorswon  incollege?
9101112
Yearsof
participation
PERSONAL STATEMENT
 Birmingham-Southern College is committed to the total development of each and every student. Your application and resume may give us a partial
view of who you are and what you hope to accomplish. A Personal Statement, however, will give us a greater opportunity to learn more about the
  “whole” you. Please write or type a 250-500 word personal statement on any topic of your choice. Topics may include a signicant life experience,
personal aspirations, the importance of a Birmingham-Southern College liberal arts education, or local, national or international concerns. Your
  statement should include your name, a title, and page number(s). Please carefully revise and edit your statement as all qualities of good writing
including structure, grammar, and spelling will also be considered.
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I certify that the above statement is accurate and my own work. If my application is approved, I agree to abide by the policies, rules, and regulations
of Birmingham-Southern College.
Signature __________________________________________________________ Date______________________________________
SCHOOL RECOMMENDATION
TO THE STUDENT
Pleasecompletetheinformationbelow,sign,andsendformtoyourhighschoolcounselor,ortotheDeanofMen/Women/Studentsattheinstitutionyou
are currently attending, or to the appropriate person at the last school in which you were enrolled.
Name _________________________________________________________________________ Social Security Number___________________
Last First Middle
Address ____________________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP
q I waive my right of access to this form once it is completed. q I do not waive my right of access to this form once it is completed.
qIauthorizetheBirmingham-SouthernCollegeAdmissionOfcetosolicit/requestanymissingorneededmaterialfrommyhighschoolforthepurpose
of evaluating me for admission.
Date____________________________Student’sSignature____________________________________________________________________
TO THE COUNSELOR OR DEAN
ThestudentabovehasappliedtoBirmingham-SouthernCollege.Pleasecompletetheinformationrequestedbelow,attach a written letter of
recommendationandreturnthisformto:OfceofAdmission,900ArkadelphiaRoad,Box549008,Birmingham,Alabama35254.Thankyou.
1.Hasthisstudenteverbeenunderacademicdiscipline,orsocialdisciplineand/orbeensuspendedorexpelledwhileatyourschool?
qYesq No If yes, please explain. ____________________________________________________________________________________
___________________________________________________________________________________________________________________
2.Pleaseprovideuswiththestudent’shighestSATorACTtestscores(ifavailable).
SAT-CR___________ SAT-M___________ SAT-W_____________ COMBINED__________
ACTEH__________ ACTMA__________ ACTREAD.__________ ACTSCI.REAS.__________COMPOSITE______________
3.Pleaseprovidethisstudent’scumulativeGPAandclassrank.Ifyourschooldoesnotrankstudents,pleaseindicatethemostaccuratedecileforthisstudent.
GPA__________ Rank__________/__________or__________Decile
q School does not rank students.
4.Myrecommendationofthisstudent’sacademicabilitycanbecharacterizedas:
q Enthusiastic q Strong q Moderate q With reservations q I do not recommend this student.
Please contact me for additional information.
5.Myrecommendationofthisstudent’scharactercanbecharacterizedas:
q Enthusiastic q Strong q Moderate q With reservations q I do not recommend this student.
Please contact me for additional information.
Signature _________________________________________________________________ Date _____________________________________
Name ____________________________________________________________________ Position __________________________________
School _____________________________________________________________________________________________________________
Address ____________________________________________________________________________________________________________
Number, Street, or P.O. Box City State ZIP
OfceTelephone_(___________)_________________________________________________________________________________________
E-Mail Address _______________________________________________________________________________________________________
900 Arkadelphia Road
Box 549008
Birmingham, AL 35254
Call: 1-800-523-5793
(toll-free), ext. 4696
or 205-226-4696
Fax: 205-226-3074
admission@bsc.edu
www.bsc.edu
Apply Online
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