Connect to BSU!Completing this form will help the BSU at your future school connect with you. Person Completing Form * -- Student Parent Church Staff Other Student's Name * First Name Last Name Type of Student Incoming Freshman Transfer Student Future College/University * -- Blue Mountain College Co-lin Community College Delta State University East Central Community College East Mississippi Community College Mississippi Gulf Coast Community College Hinds Community College Holmes Community College Itawamba Community College Jackson State University Jones College Meridian Community College Mississippi College Mississippi Delta Community College Mississippi State University Mississippi University for Women Northeast Mississippi Community College Northwest Mississippi Community College Pearl River Community College Southwest Mississippi Community College University of Mississippi University of Southern Mississippi William Carey University Student's Home Church Student's Phone * (###) ### #### Student's Email * Student's Permanent Address * Address 1 Address 2 City State/Province Zip/Postal Code Country
