Minot State University - Center for Extended Learning

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Request for Information for Distance Education Programs

Thank you for your interest in Minot State University. Minot State University offers distance education programs via the Internet, on the Bismarck State College campus and at Minot Air Force Base. If you would like to learn more about Minot State University, the application process, course registration and course offerings, visit:

This is an information request, not an application. Please use upper and lower case letters when spelling names and addresses.

If you would like to speak with a representative from Minot State University, please call 701-858-3822 (Minot), 701-224-5496 (Bismarck), 701-727-9044 (Minot Air Force Base), or call toll free 1-800-777-0750. We will be glad to visit with you regarding your decision to complete a college education at Minot State!

Name

Last Name:

First Name:

Home Address

Home Street Address:

Home City:

State/Province

Home Zip:

Country:

Telephone Numbers

Home Telephone:

Daytime Telephone:

Email Address

Email Address:

Gender

Gender:

Female Male

Birth Information

Date of Birth:

Educational Background

Were you previously a student at MSU?

Yes No

Your level of college/university education?

No college
Some college
Two-year degree
Four-year degree
Masters degree

Program Information
Please indicate all the areas you would like to receive information:

Online
MS in Management
MS in Information Systems
BS Virtual Business
BS Management
BS Management Information Systems
Bachelor General Studies
BAS with a major in Applied Management
BAS with a major in Applied Business Info. Tech.
AS with Emphasis in Developmental Disabilities
Desktop and Web Publishing UG Certificate
Application Software Specialist UG Certificate

Bismarck State College Campus
BS in Criminal Justice
BS in Management
BS in Social Work
BA in Psychology

Minot Air Force Base
BS in Criminal Justice
Bachelor General Studies
CCAF Courses

Semester of Enrollment Anticipated

Which semester do you expect to enroll in your first class?

Summer Semester 2007
Fall Semester 2007
Spring Semester 2008

Transferring

Are you transferring from another institution?

Yes No

Completion

What portion of your degree do you anticipate completing from Minot State?

Less than half
More than half
All of the degree courses

Marketing

How did you find out about Minot State University Internet degrees?

Direct Mailer
Friend/Family
Business
Internet
Other

Questions/comments: