Request Information
BEACON COLLEGE

The nation's only four-year accredited college exclusively for students who have language-based learning disabilities or Attention Deficit/Hyperactivity Disorder.

We look forward to supplying you with additional information about Beacon College. (*required Information)

Candidate's Name*:
Parent/Guardian:
Address*:
City*:
State*:
Zip*:
Phone*:
Email*:
I am a:	Future Student Parent Alumni Corporate Partner Other
Name of High School:
High School Diploma Type:	Standard GED
Anticipated Entry Term:	Year: Spring (January) Fall (August) Freshman Transfer
Degree:	BA AA
Major:	Liberal Studies Human Services Computer Information Systems CIS, Information Systems Track CIS, Web & Digital Media Track Undecided

 
Gender and ethnicity information is optional. It is used for institutional reporting and will not affect the outcome of your application.

Gender (optional):	Male Female
Ethnicity (optional):	African American Alaskan Native or American Indian Asian American or Pacific Island American Latino/Hispanic White (non-Hispanic) Other

 

How did you learn about Beacon College?:
Additional Questions/Comments: