ADMISSIONS APPLICATION

Transcription

1 Coastal Carolina Community College ADMISSIONS APPLICATION Admissions Office 444 Western Boulevard Jacksonville, North Carolina (910) Monday - Thursday, 8:00 a.m. - 7:30 p.m. Friday, 8:00 a.m. - 5:00 p.m. The Application Process 1. Complete the Application for Admission Complete all the requested information, sign, and return the application to the Admissions Office in the Student Center. You may mail it or submit it in person. No application fee is required. 2. Determine English and Mathematics Placement Requirements Assessment of each applicant s competencies in English and mathematics is required for placement into college level courses. Students who can provide evidence of the following should meet with an academic counselor to determine if placement testing is necessary. o former Coastal students o students who have taken the SAT or ACT within the past three years o students who have transfer credit in English or mathematics o students who have recently taken a placement test at another community college. Note: Placement tests are valid for 36 consecutive months from the month of administration. Students may take the entire placement test twice under the administration of the College within a two-year period. Applicants who meet any of the above criteria should call (910) to speak with an academic counselor. For applicants who are required to take placement tests, the college provides this service on a regular basis at no cost. Performance on placement tests in reading, writing, and mathematics determines initial placement into college level mathematics and English. Information about placement testing, including a study guide in mathematics, is available in the Admissions Office. 3. Submit Transcripts Submission of official transcripts is mandatory for admission to a program. Send the Transcript Request Form (enclosed in this packet) to your high school, or furnish the Admissions Office with an official copy of your high school equivalency/ged scores. In addition, send a Transcript Request Form to all colleges you have previously attended. You are responsible for ensuring that the Admissions Office receives all of your transcripts. Students may be accepted under a provisional status and allowed to register for classes in cases where official transcripts will arrive after the semester begins. 4. Meet with an Academic Counselor Call or visit the Admissions Office and arrange to meet with an academic counselor. The counselor will provide you with the college catalog, assist in planning a program of study, and help with class registration. Rev. 6/2014 page 1

2 Coastal Carolina Community College Academic Majors with Curriculum Codes Associate Degree Programs Associate degrees are offered in the arts (A.A.), science (A.S.), and fine arts (A.F.A.) for students who aspire to transfer to a four-year college or university. The 60/61 semester credit hours of coursework leading to these degrees is designed to parallel the freshman and sophomore years of study at four-year colleges and universities. A10100 Associate in Arts A10200 Associate in Fine Arts A10400 Associate in Science Associate in Applied Science Degree Programs Associate in Applied Science (A.A.S.) programs are designed to provide entry-level employment training in technical areas. A.A.S. programs range from 64 to 76 semester credit hours. A full-time student can typically complete one of these programs in two years. A25100 Accounting A45260 Dental Hygiene** A45630 Health and Fitness Science A35100 Air Conditioning, Heating, and A55220 Early Childhood Education A25110 Hospitality Management Refrigeration A40200 Electronics Engineering A45420 Medical Laboratory A40100 Architectural A25310 Medical Office Administration A45110 Associate Degree Nursing** A55460 Emergency Management** A25340 Networking Technology A25260 Computer Information Technology A45340 Emergency Medical Science** A25370 Office Administration A25130 Computer Programming A45340B Emergency Medical Science - A25380 Paralegal Technology A55180 Criminal Justice Technology Bridging** A25290 Web Technologies A5518A Criminal Justice Technology - A25330 Financial Services Latent Evidence A55240 Fire Protection Diploma Programs Diploma programs are designed to provide entry-level employment training. Diploma programs range from 36 to 48 semester credit hours and can usually be completed by a full-time student within one calendar year. Associate degree level courses within a diploma program may also be applied toward an A.A.S. degree program. D35100 Air Conditioning, Heating, and Refrigeration D45240 D60460 Dental Assisting** Diesel and Heavy Equipment D55460 D55240 Emergency Management** Fire Protection D40100 Architectural D25110 Hospitality Management D60160 Automotive Systems D55220 Early Childhood Education D45660 Practical Nursing* D60130 D55140 Collision Repair and Refinishing Cosmetology D35220 D40200 Electrical Systems Electronics Engineering D45740 D50420 Surgical Technology* Welding Certificate Programs Certificate programs are designed to provide short-term focused entry-level employment training. Certificate programs range from 12 to 18 semester credit hours and can usually be completed within one to four semesters. Certificate courses may also be applied toward a related diploma or A.A.S. degree program. C40200A Advanced Electronics Applications # C35100E Comfort Cooling** C55240D Fire Supervisor** C40100 Architectural Drafting and Design I** C35130A Commercial Electrical Systems # C25110F Food and Beverage C40100A Architectural Drafting and Design II** C40200C Computer Technology* C35100C Heating and Cooling Systems** C60160 Automotive Systems C60160E Automotive Systems Technology - Engine Performance # C60160P Automotive Systems Technology - Powertrain** C60160U Automotive Systems Technology - Undercar # C40200 Basic Electronics** C55120 Basic Law Enforcement Training C35100B Basic Refrigeration** C25100P Bookkeeper/Payroll Clerk C50420C Certified Welder** C25340 CISCO C60130H Collision Repair Advanced # C60130G Collision Repair Intermediate # C60130F Collision Repair Introductory** C60130E Collision Repair and Refinishing C50420B Combination Welder # C55160 C60460 Cosmetology Instructor** Diesel and Heavy Equipment C40100B Digital Design # C55220A Early Childhood Administration C55220 Early Childhood Education C55460 Emergency Management** C55460A Emergency Management - Administration # C55460I Emergency Management - Infrastructure** C55460M Emergency Management - Mitigation and Preparedness** C55460P Emergency Management - Planning** C55460R Emergency Management - Response and Recovery** C55240 Fire Protection General Level** C55240C Fire Protection General Level 2** C55240A Fire Investigator Level** C60460T Heavy Duty Truck Systems # C25110 Hospitality Fundamentals C35100D HVAC Designs and Installation* C55240B Incident Command Level** C25100B Income Tax Preparer C35130B Industrial Electrical Systems # C55290 Infant/Toddler Care C55430 Lateral Entry C55400 Manicuring/Nail C25310B Medical Billing and Insurance C25310 Medical Office Administration** C25310A Medical Transcription** C60460B Medium/Heavy Duty Drive Train # C60460A Medium/Heavy Duty Power Train** C25370 Office Administration C35130 Residential Electrical Systems** C35100F Residential Technician** C55450 School-Age Care** C50420A Structural Welder** * Summer entry only ** Fall entry only # Spring entry only page 2

3 Coastal Carolina Community College Application Please print or type. Answer all questions. The information for items 2, 6, 7, and 11 is voluntary and will not be used in decisions regarding admission. o New student application o Re-admission application Section I. Personal Information 1) Name last first middle last name at birth (if different) (2) Social security number (3) Local mailing address street city state zip (4) Home telephone Work telephone (5) address (optional) (6) Sex o female o male (7) Date of birth (8) Employment status (choose one) o retired o unemployed - not seeking employment o unemployed - seeking employment Hours per week o employed 1-10 o employed o employed o employed 40 or more (9) U.S. citizen o yes o no If no, country of citizenship (10) Visa status o permanent resident alien o student visa o other visa visa expiration date (11a.) Ethnicity o Hispanic or Latino (11b.) Race (If Non-Hispanic) o American Indian or Alaska Native o Asian o Black or African American o Native Hawaiian or Other Pacific Islander o White Section II. Academic Major/Date of Entrance Indicate below the academic major to which you wish to be admitted. Academic majors and curriculum codes are listed on page 2. Please note that there are application deadlines for some academic majors. (12) Academic major (see page 2) Curriculum code (see page 2) (13) Entry term (choose one) o fall (August-December) o spring (January-May) o summer (May-August) calendar year 20 (14) Long-term goals o obtain degree, diploma, certificate o enhance job skills for current field of work o enhance job skills for new line of work o take courses to transfer o take courses for personal interest page 3

4 Section III. High School/Secondary Education Information (15) High school graduation status (choose one) o graduated from high school or expect to graduate from high school prior to enrollment (complete Section III, Part A) o did not graduate from high school but have high school equivalency diploma/ged (complete Section III, Parts A and B) o did not graduate from high school but have Adult High School Diploma (complete Section III, Parts A and C) o did not graduate from high school and have no high school equivalency (stop here and contact the Admissions Office at ) If you plan to enter an academic program, official transcripts are required from the school awarding the high school diploma or equivalency. Part A - High School Last Attended (regardless of graduation status) (16) Type of school o public o private o home school o other (17) High school name city county state/country (18) Date of high school graduation (actual or expected) (19) Date of last attendance (non-graduate) Part B - School/Agency Awarding High School Equivalency Diploma/GED (20) Type of school p community college p university p state/government agency p other (21) School/agency name city county state/country (22) Date high school equivalency diploma/ged awarded Part C - School/Agency Awarding Adult High School Diploma (23) Type of school p community college p university p state/government agency p other (24) School/agency name city county state/country (25) Date Adult High School Diploma awarded page 4

5 Section IV. College/Post-secondary Information (26) Highest degree/diploma completed p vocational diploma p associate degree p bachelor s degree p master s degree or higher (27) List all colleges you have attended or are currently attending. Attach list on a separate sheet if necessary. Failure to furnish full information may jeopardize academic major classification, eligibility for graduation, and/or financial aid awards. Name City/State Attended From To If you plan to enter an academic program, official transcripts from all colleges and/or other post-secondary schools are required. Section V. Residency Statement (must be completed by ALL applicants) North Carolina Law (G.S ) requires that To qualify as a resident for tuition purposes, a person must have established legal residence (domicile) in North Carolina and maintained that legal residence for at least the twelve months immediately prior to his or her classification as a resident for tuition purposes. Every applicant for admission shall be required to make a statement as to his length of residence in the State. Please check one of the two boxes listed below and complete litems o Resident: This is to certify that I have been a legal resident, or (if under 18) my parents have been legal residents of North Carolina for the twelve months immediately preceding the date on which I will enroll at Coastal Carolina Community College. o Non-Resident: In applying for admission to Coastal Carolina Community College, I acknowledge my ineligibility for the resident tuition rate. (A petition for reclassification may be filed at the end of the qualifying twelve month domicile period.) (28) Are you a resident of North Carolina? o yes o no If yes, list county: (29) Have you lived in North Carolina continuously for the past 12 months? o yes o no (30) In what state do you pay State Income Tax? (31) Do you have a North Carolina drivers license? o yes o no If no, list state issued: Driver s License Number: (32) Are you registered to vote in North Carolina o yes o no If no, list state registered: (33) Were you or a member of your immediate household transferred by an employer to North Carolina? o yes o no If yes, list employer s name and address Note: Students who wish to be classified as in-state residents for tuition purposes may be required to complete an Application for Classification as a Legal Resident (Domiciliary) of North Carolina for Tuition Purposes. Students may also be required to provide other documents that can show additional proof of residence. page 5

6 Section VI. Active Duty Military and Active Duty Military Dependents Information This section should be completed by all active duty military personnel and all dependents of active duty personnel regardless of legal residency. Complete the section that is applicable. Give complete answers to all items. (34) Active duty military status Are you currently active duty military? o yes o no (If yes, complete Part A only) Are you currently a dependent of active duty military personnel stationed in NC? o yes o no (If yes, complete Part B only) Part A - Active Duty Military (35) Anticipated active duty separation date State of residence as indicated on your LES (36) Your branch of service o Air Force o Army o Coast Guard o Marine Corps o Navy (37) Name and location of your unit Part B - Active Duty Military Dependents (38) What is your relationship to your sponsor? o husband o wife o child o other (specify) (39) Do you live with your sponsor? o yes o no (40) Your sponsor s name last first middle last name at birth (41) Your sponsor s anticipated active duty separation date State of residence as indicated on your sponsor s LES (42) Your sponsor s branch of service o Air Force o Army o Coast Guard o Marine Corps o Navy (43) Name and location of unit page 6

7 Section VII. In Case of Emergency (all applicants must complete) (44) Person to contact Name Relationship to the applicant (45) Address (46) Day telephone Night telephone (47) Are you allergic to any medication or materials? o yes o no If yes, explain (48) Personal History: Please indicate in the space below any conditions, ailments, or problems which you feel may be helpful for school officials to know in the event you were to have an accident, illness, or other emergency health problem while on campus. Coastal reserves the right to transport students to the nearest medical facility in the event of an emergency. Section VIII. Selective Service Registration (49) If you are a male and are required to register with Selective Service, have you done so? o yes o no Section IX. Acknowledgements Admission to any and all educational programs offered by Coastal Carolina Community College is made without regard to race, color, sex, religion, national origin, physical handicap, or other irrelevant factors. Coastal attempts to comply with section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act. If you have a disability and wish to request some accommodation, contact the Admissions Office, and ask for the Request for Accommodation Form. If accommodation is not requested in advance, so as to provide the college sufficient and adequate time to meet your needs, we cannot guarantee the availability of a reasonable accommodation when you need it. This form is an application for admission, not a guarantee of admission. I hereby acknowledge that the completion of all items containing my social security number is voluntary and is requested by the institution solely for administrative convenience and record-keeping accuracy. My social security number is requested only to provide a personal identifier for the internal records of this institution. I certify that all the information given on this application is correct to the best of my knowledge, pursuant to reasonable inquiry where needed, and I am aware that any knowing falsification hereon may result in disciplinary action including denial of admission or dismissal after admission. Coastal reserves the right to require documentation of information contained on, or changes made to, this application. (50) Signature of applicant (51) Date (52) Signature of parent or guardian (if applicant is under 18) (53) Date page 7

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