Francis Marion University - Oce of Admissions

Bridge Program Enrollment Form

Student Information:

___________________________________________________________________________________________________________

First Name Middle Name Last Name

Preferred Name ___________________________________________ Date of Birth ______________________________________

Mailing Address _____________________________________________________________________________________________

Street Address/Apartment number (if applicable)

___________________________________________________________________________________________________________

Completed number of college credits (if none, list N/A) ______________________________________________________________

Anticipated number of college credits before transferring _____________________________________________________________

Intended FMU major _________________________________________________________________________________________

Intended FMU entry term (choose one) ❏ Late Spring ❏ Sum I ❏ Sum II ❏ Fall ❏ Spring Year ___________

Have you ever submitted an admissions application to FMU? ❏ Yes ❏ No

Demographic Information: ALL APPLICANTS MUST COMPLETE

Are you Hispanic/Latino? ❏ Yes, I am Hispanic/Latino. ❏ No, I am not Hispanic/Latino.

Regardless of your answer to the prior question, please select one or more of the following races that best describe you:

❏ American Indian or Alaska Native ❏ Asian ❏ Black or African American

❏ Native Hawaiian or other Pacic Islander ❏ White

(Complete this section if you are working with a specic technical college advisor who is assisting you in the transfer process.)

Name _____________________________________________________ Date __________________________________________

College ____________________________________________________________________________________________________

Contact Info ________________________________________________________________________________________________

Phone Number Email

Return to:

Oce of Admissions Phone: 843-661-1231

Francis Marion University Toll free: 1-800-368-7551

PO Box 100547 Fax: 843-661-4635

Florence, SC 29502 Email: admissio[email protected]

• Participants must complete at least 22 transferable credit hours with a cumulative GPA of 2.0 or higher.

• Participants must ll out an update application form at least two months prior to the start of the desired semester entry.

• Participants are personally responsible for meeting eligibility requirements for grants, loans, scholarships and other nancial

assistance programs at Francis Marion University.

• FDTC Bridge participants MUST be enrolled in the FMU University Life course that will be taught at FDTC.

Printed Name _______________________________________________________________________________________________

Signature _________________________________________________ Date ____________________________________________

Received by __________________________________________ Received by __________________________________