I am applying for: *

Spring/Summer

Fall

Winter

Part 1: STUDENT INFORMATION

First, middle, and last name exactly as they appear on your passport: *

Personal Name Preference:

Sex: *

Birth date: *

Month

Day

Year

Current University: *

BYU ID #: *

Enter the following format: ##-###-####

Net ID: *

Current Major: *

Current Student Classification: *

Phone Number: *

Enter the following format, including area code: ###-###-####

BYU-designated Email: *

Please note that we will exclusively use this email for all correspondence.

Current Mailing Address: *

City: *

State/Province: *

ZIP/Postal Code: *

Are you a citizen or permanent resident of the United States? *

Country of citizenship: *

Additional materials may be required of non-U.S. citizen applicants.

Country of birth: *

Type of current visa: *

Visa, other: *

Please explain.

Religious Affiliation

Religious affiliation: *

Religion, Other: *

Please specify

Home ward: *

Home stake: *

Have you served an LDS mission? *

Date entered MTC: *

Month

Day

Year

Date released: *

Month

Day

Year

Current name of mission: *

Passport Information

Do you have a current passport? *

Passport Number: *

Place of Birth: *

Nationality: *

Passport Issue Date: *

Month

Day

Year

Passport Expiration Date: *

Month

Day

Year

Please enter date of passport application: *

Month

Day

Year

Upload a picture of your passport: *

Files must be less than 10 MB.
Allowed file types: jpg jpeg png pdf.

Family Emergency Contact 1

Relationship: *

Relationship, Other: *

Please explain.

Name: *

Mailing Address: *

City: *

State/Province: *

ZIP/Postal Code: *

Phone Number: *

Enter the following format, including area code: ###-###-####

Email: *

Family Emergency Contact 2

Relationship: *

Relationship, Other: *

Please explain.

Name: *

Mailing Address: *

City: *

State/Province: *

ZIP/Postal Code: *

Phone Number: *

Enter the following format, including area code: ###-###-####

Email: *

Legal Statement: *

I hereby certify all statements in this application are complete and true and acknowledge that my admission and my continuing status are conditional on such completeness and truthfulness.

Admission Application

Part 1: STUDENT INFORMATION

Religious Affiliation

Passport Information

Family Emergency Contact 1

Family Emergency Contact 2

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