STUDENT'S COMMITMENT AND CONFIDENTIAL REPORT

Please note: This form must be completed and signed by a bishop or branch president (LDS applicants), or by an appropriate religious official for non-LDS applicants as listed below under Purposes and Directions.

Applicant's Name: ____________________________________ Religious Affiliation LDS (Mormon) Other ____________________

Birthdate: ______________________ When do you plan to begin your studies? ________________________________________________

Directions
The intensive English language program available at the English Language Center is of greatest value to a student when that student is deeply committed to the behavioral, moral, and spiritual standards contained in the Code of Honor, and the Dress and Grooming Standards. To insure that the prospective student is fully informed of and committed to the standards expected by BYU and the English Language Center, this confidential report should be completed during an interview with the applicant by an LDS bishop or branch president if the applicant is a member of the Church of Jesus Christ of Latter-day Saints.
Applicants who are not members of the Church of Jesus Christ of Latter-day Saints may be interviewed by a Church of Jesus Christ of Latter-day Saints (Mormon) bishop, branch president, stake president, or mission president. If an LDS church bishop or branch president is not available, the non-LDS applicants may also be interviewed by a clergyman/woman of their own faith.

CODE OF HONOR

  1. Do you live the law of chastity?
    This includes abstinence from all sexual relations outside the bonds of marriage.
  2. Do you observe the Word of Wisdom?
    This includes abstinence from alcoholic beverages, tobacco (no smoking or any other use of tobacco), tea and coffee.
  3. Do you respect property rights?
    This includes refraining from shoplifting, concealment, damage, or misuse of the property of other.

Please have the interviewing official mail this form to:
Dr. Glen Probst, Administrative Coordinator
English Language Center
4056 JFSB
Brigham Young University
Provo, Utah 84602
Phone: (801) 422-2691 Fax: (801) 422-0474

  1. Have you been involved in drug abuse?
    This includes the possession, use, or distribution of any narcotic or dangerous drug (as defined by applicable law), except as prescribed by a licensed medical practitioner.
  2. Will you comply with all University regulations?
    This includes compliance with rules relating to campus organizations and to the use of University or off-campus or other facilities.
  3. Will you respect personal rights?
    This includes-
    a. not physically or verbally abusing any person and not engaging in conduct that threatens or endangers the health or safety of others; and
    b. not obstructing or disrupting the study of others; the performance of official duties by University personnel; the teaching, research, disciplinary, administrative, or other functions of the University premises.
  4. Do you currently obey, honor and sustain the law?
  5. Are you honest in all behavior?
    This includes not cheating, plagiarizing or knowingly giving false information.
  6. Do you live the standard of Christian living taught by the Church of Jesus Christ of Latter-day Saints?
    This includes graciousness and consideration for others and the observance of high principles of honor, integrity, and morality.
  7. Do you observe high standards of taste and decency?
    This includes refraining from disorderly, lewd, indecent, or obscene conduct and expression.
  8. Will you observe University standards of dress and grooming as outlined?
  9. Will you help others fulfill their responsibilities under the code of honor?

 

DRESS AND GROOMING

The dress and grooming of both men and women should always be modest, neat, and clean, consistent with the dignity of a representative of Brigham Young University and the Church of Jesus Christ of Latter-day Saints.

Clothing should be modest in fabric, fit, and style, and appropriate for the occasion. Closing should be knee-length or lower. Clothing which is sleeveless, strapless, or revealing is not acceptable. Excessive ear piercing on women (more than one per ear) and all other body piercing are not acceptable. Shoes should be worn in public campus areas.

A clean and well-cared-for appearance should be maintained. Hairstyles should be clean and neat, avoiding extreme styles and colors. Men's hair should be trimmed above the collar, leaving the ear uncovered. Earrings on men and other body piercing are not acceptable. Men should be clean-shaven. Beards are not acceptable, except for certified medical or religious reasons. If worn, mustaches should be neatly trimmed. Men's sideburns should not extend below the earlobe or onto the cheek.

APPLICANT'S COMMITMENT
I have read the Code of Honor and Dress and Grooming Standards and hereby commit myself to do the following both on and off campus while enrolled at the English Language Center if I am admitted or re-admitted:

a. Conduct my personal life consistent with the standards of Christian living taught by The Church of Jesus Christ of Latter-day Saints;

b. Adhere to the other requirements of the attached Code of honor and Dress and Grooming Standards as defined by the Board of Trustees.

c. I agree that the University may obtain confidential recommendations from church leaders and High School counselors concerning my application for admission and hereby waive any right I may have under university policies or federal or state law to examine confidential recommendations received by the English Language Center.

______________________________________________________

 

________________________________

Signature of applicant

 

Date

 


Interviewing Officer's Endorsement
It is essential that an unworthy student not be recommended for attendance in the English Language Center at BYU, but that the student get his/her life in order and then be recommended. I have thoroughly reviewed the requirements contained in the Code of Honor and Dress and Grooming Standards with the applicant.

a. The applicant IS NOW ABIDING by all of these requirements Yes No. (If response is no, please comment.)

________________________________________________________________________________________________________

________________________________________________________________________________________________________

b. In my opinion the applicant WILL CONTINUE TOABIDE BY THESE REQUIREMENTS during enrollment.

Yes No. (If response is no, please comment.)

________________________________________________________________________________________________________

________________________________________________________________________________________________________

c. If the applicant is currently excommunicated ordisfellowshipped from The Church of Jesus Christ of Latter-day Saintsor on probation to a Church Disciplinary Council.

NOTE: If you have confidential information whichmay be grounds for denial to this student, please attach a separateletter.

________________________________________

 

____________________

 

______________________________________

(Signature of interviewer)

 

(date)

 

Church Position or Title

 

________________________________________

 

______________________________

______________________________

Name of Interviewer (please print)

 

Ward/Branch

Stake/Mission

 

Address

________________________________________________________________________________________________

 

Number and street

city

state

country

zip code

 

Phone

_____________________________

 

Fax (optional)

_________________________

 

Email (optional)________________________

 

Country Code — City Code — Number

 

 

Country Code — City Code — Number

 

 



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