Benedict College - Intent to Enroll (August 2020)
Please complete this form and submit your required fees. It is very important that you submit your fees to secure your space for August 2020. All required information must be filled in. Please note your Admissions fee ($50) and Housing fee ($100) are due by May 1. Should you have any questions, please email us at for assistance.

By submitting this form, you agree that you have reviewed this information and you certify that the information provided is true and accurate to the best of your knowledge. Completing the Intent to Enroll form means you intend to attend Benedict College for the Fall 2020 semester.
Benedict Student ID#: *
Name (Last Name, First Name): *
Home Address (Street, City, State and Zip): *
Student Email Address: *
Preferred Contact #: *
Gender Identity: *
Date of Birth: *
What is your intended academic major? Check one. *
Have you paid the $50 Admissions Fee and the $100 Housing Fee? *
Check the following option(s) that best describes your housing preference. *
Do you have health insurance? (policy information must be shared with the Health Center)
Clear selection
Please indicate any dis/abilities that require technical accommodations (e.g. blindness, deafness, ADHD). *
Have you submitted your Health Form? (This document is required before you will be allowed to live on campus.) *
Are you making a payment today? This form can be submitted without a payment. *
Please let us know if you have additional questions or comments.
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