Student Application (Please answer all questions)
There are two steps for correspondence enrollment, and three steps for online enrollment at MBC.
1. Fill out the application below
2. Pay the application Fee $25.00
(you will be redirected to the registration payment page upon submission of the form)
3. Setup Your User Name and Password (if applying for online enrollment)
Step 1 - Online Application (Please answer all questions)
Are you applying for Correspondence or Online courses? *
Did you read and do you agree to abide by MBC Policies? *
You must agree to MBC Policies
First Name *
Your answer
Middle Name or Maiden Name *
Your answer
Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Country *
Your answer
Email Address *
Your answer
Marital Status *
Gender *
Last 4 numbers of your Social Security Number *
Your answer
Name of Spouse *
Your answer
Phone Number *
Your answer
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