Fillable Admission Procedures ranscript, GED, HiSET or MSUB Readiness (Montana State University - Billings)

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Admission Procedures ranscript, GED, HiSET or MSUB Readiness (Montana State University - Billings)

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Send or Submit application for
admission to:
Jacket Student Central
City College at MSU Billings
3803 Central Ave.
Billings, MT 59102
For additional information
Jacket Student Central
City College at MSU Billings
406-247-3007 or
800-565-MSUB ext. 3007
admissions@msubillings.edu
citycollege.msubillings.edu
Admission Procedures
1. High School t
ranscript, GED, HiSET or MSUB Readiness Test scores.
If you are a first-time student with fewer than 12 college credits, submit a copy of your current high school transcript and a final
high school transcript when you graduate, or GED, HiSET or MSUB Readiness Test scores for review. City College students are not
required to submit ACT or SAT scores, however these scores will help with class placement.
2. All Previous College Transcripts
If you are a transfer student, request official, complete transcripts from all previous colleges to be sent directly to Jacket Student
Central. An evaluation of your transfer credits will be completed after you apply for admission. If you have sealed official
transcripts, please submit them unopened.
3. Immunization Records
If you were born after December 31, 1956, submit proof of immunization. The immunization dates must also be after your
first birthday. Requirements include proof of two (2) doses of immunization against measles (Rubeola) and (2) doses of
immunization against Rubella given at least 30 days apart. Include month/day/year. Any immunizations administered after
June 11, 1993, must be an MMR. The record must be signed by a physician, health agency, or school official.
Apply for Scholarships Online!
Freshmen and transfer student scholarships will be awarded continually beginning in
December. Priority will be given to those who apply before February 1.
To apply for scholarships, apply for admission first at: msubillings.edu/future/apply.
Once accepted complete the scholarship application at:
msubillings.edu/scholarships
(You will also need your student ID number to apply for scholarships.)
Apply Early to be considered for scholarships!
Must have applied for admission to be eligible for scholarships.
1
For complete information on admission requirements please go to: msubillings.edu/future/apply
For the most current listing of all the degree options including Associate’s, Bachelor’s and Master Degree’s please visit: msubillings.edu.
For more information on the City College gainful employment programs, such as cost, nancial assistance and placement rates, please go to: msubillings.edu/citycollege/Gainful_Employment.htm
Please type or print all information. A non-refundable application fee of $30 must accompany this application.
Institutional
Institutional Information
Desired term of enrollment: Fall term 20 Spring term 20 Summer term 20
Were you previously enrolled at City College or Montana State University Billings? Yes No
Dates of attendance:
and/or dates of continuing education or extension enrollment:
Personal Information
Full Legal Name
Last First Middle
Previous Name(s)
Social Security Number – –
We ask that you voluntarily provide this number, which permits the school to distinguish between individuals of the same or similar names. This is especially
important should you request a transcript at a later date or wish to be considered for nancial aid. You will not be penalized should you decline to provide your social
security number.
Permanent address
City State Zip Phone number ( )
If Montana, indicate county
Mailing address
City State Zip Phone number ( )
Cell Phone Number ( ) E-mail address @
Birthdate / / Birthplace
Parent(s)/Guardian(s) Names (if you are a dependent)
Country of citizenship If not U.S., are you a permanent resident alien of the U.S.? Yes No
Emergency Contact Information:
Contact Name Relationship
Address
City State Zip
Home phone number ( )
Work phone number ( )
Cell phone number ( )
Statistical Information
Providing this information is voluntary.
City College at Montana State University Billings does not discriminate in admission, or the provision of services nor employment policies on the basis of race,
gender, national origin, marital status, creed, religion, color, age, or physical or mental handicap. Providing the following information requested by this section is
voluntary and the information provided will not be used in a discriminatory manner.
1. Gender Male Female
2. Have you served in the military for a period of active duty longer than 180 days? Yes No
3.. Has either of your parents or guardian(s) COMPLETED a bachelor’s degree? Yes No Unsure
Application For Admission
2
4. Ethnic Identity
This information is for statistical analysis only. It is not used in the admission process and will have no bearing on your admission status.
a. Indicate your ethnic identity by checking the appropriate boxes:
Hispanic / Latino Not Hispanic or Latino (check category below)
b. If not Hispanic or Latino, indicate which of one or more racial categories should be used to classify you:
American Indian or Alaska Native Specify primary tribal aliation or reservation
Asian Specify country of origin
African American
Native Hawaiian or Other Pacic Islander Specify country of origin
White
Students with Disabilities
If you have a disability that you wish to bring to the attention of the institution to which you seek admittance, you may do so, before or after admission, by submitting a request
for accommodation to either the Disability Support Services oce or the Oce of Admissions and Records. Applicants who need an alternative accessible format of this
application may request it from either of the above noted oces. All requests regarding disability will be condential and will not be used as a factor in granting or denying
admission. Disability Support Services is located in the College of Education building, room 135 and can be contacted at 657-2283/406-545-2518 (VP) or tcarey@msubillings.edu.
Educational Goal
Please indicate your educational goal:
Associate Degree or Certicate (indicate program)
Bachelor Degree (indicate eld of study or undecided)
Second Bachelor Degree (indicate eld of study)
Non-Degree Seeking Undergraduate (not pursuing a degree or certicate at this institution. Student is not eligible for nancial aid at MSU Billings)
For personal/professional development For subsequent use toward an undergraduate degree or program at this school
For transfer to another institution (specify plans)
Other
Non-Degree Seeking Graduate (bachelor degree earned; not pursuing a degree or certicate at this institution)
For personal/professional development To satisfy graduate school deciencies
For teacher certication
For transfer to another institution (specify plans)
Other
Post-Baccalaureate (bachelor degree earned)
For graduate school (Contact the Oce of Graduate Studies for additional requirements.)
For teacher certication
To satisfy graduate school deciencies
Other
Academic History
If you are or will be a high school graduate, please indicate:
Graduation date: / /
Complete name of high school
City State
What is your cumulative grade point average at this time?
Is this high school accredited by its state department/oce of education? Yes No
If you have or will receive a GED or Hi SET, please indicate date and location
3
Are you claiming in-state tuition classication as a Montana resident? Yes No (If yes, complete the following questions. If no, skip to the Safety & Security questions on pg. 5)
A. If your parent or legal guardian does NOT claim you as an income tax exemption, please complete the following. If they do claim you, then go to ITEM D.
1. Date you began living in Montana (mo/day/yr)
2. Dates of extended absences from Montana (mo/day/yr) to
Reason for absence
3. Have you led a Montana state income tax return? Yes No
as a part-year resident as a full-year resident
List the last three years Montana income taxes have been led: , ,
4. Date of your Montana voter registration (mo/day/yr)
5. Do you have a current Montana driver’s license? Yes No Issue date (mo/day/yr)
Is this a renewal? Yes No
6. Date of your current Montana vehicle registration (mo/day/yr)
7. What is your employment status? (check all that apply)
full-time part-time retired unemployed seasonal permanent
Name and address of employer
Date of start of employment
8. What is your spouse’s employment status? (check all that apply)
full-time part-time retired unemployed seasonal permanent
Name and address of employer
Date of start of employment
B. Dates of military service, if applicable (mo/day/yr) to
City and state from which you entered the service
C. I am or will be a graduate of a Montana high school after attending that school for my entire senior year, and I have or will be registering at a unit of the Montana State
University System within four fall terms of my high school graduation. Yes No
4
Residency Information
Were you ever suspended/dismissed for academic reasons from any of the institutions listed above? Yes No
If yes, please describe
If you have attended or are attending a college or university or have military or dual credits, degree seeking students must provide the following information for each institution,
whether or not credit was earned.
Complete School Name Location
Attendance period
(term/year - term/year)
Degrees/credits
earned
Cumulative
G.P.A.
Montana residents, please carefully complete all of the following items. Failure to complete the information may result in you being misclassied. If any of the
information is not applicable (NA) you may be asked to complete a Residency Questionnaire. Month and year are sucient for dates more than two years past. In
addition to your own information, if your parents claim you as a tax exemption, provide information on your parent or court appointed guardian.
D. Does your parent or legal guardian claim you as a federal income tax exemption? Yes No If no, go to question E.
If yes, please complete the following about your parent/guardian.
1. Who claims you as a federal tax exemption?
Name Relationship
2. Date he/she began living in Montana (mo/day/yr)
3. Dates of extended absences from Montana (mo/day/yr) to
Reason for absence
5
Safety and Security
This section must be completed by all applicants.
A felony in Montana State law is dened as a crime for which more than one
year in prison may be imposed.
1. Have you ever been convicted of a felony (please include instances of
deferred sentencing)?
Yes No
2. Have you ever been subjected to court-ordered connement for
threatening or causing physical or emotional injury to persons or property?
Yes No
Suspension is dened as a sanction imposed for disciplinary reasons that results in a student
leaving school for a xed time period, less than permanently. Dismissal from a college for
disciplinary reasons is dened as permanent separation from an institution of higher
education on the basis of conduct or behavior.
3. Have you ever been disciplined, suspended from, or placed on probation at any
educational institution for non-academic reasons?
Yes No
4. Have you ever been required to register as a sexual or violent oender?
Yes No
An armative response to any of these questions will not automatically prevent admission, but you will be asked by the college to provide additional information. This information will be reviewed by a
campus committee to ensure campus safety. Any falsication or omission of data may result in a denial of admission or dismissal.
Reasons for Applying
1. Who was the most inuential in your decision to apply to City College at Montana State University Billings?
Parents or relatives Guidance counselor Admissions personnel Athletics personnel University Faculty
2. Which of the following factors inuenced your decision the most to apply to City College at Montana State University Billings?
(select up to three)
Location Size of student population Cost Academics
Overall reputation Financial Aid/Scholarship Athletics/Extracurricular activities
3. Why are you applying to City College at Montana State University Billings?
For educational fulllment To learn specic skills for a new job To complete general education classes before transferring elsewhere
4. Which of the following did you nd most helpful in learning about City College at Montana State University Billings?
Campus visit Publications Web page Visit with Admissions / New Student Services personnel
Signature
I hereby certify that to the best of my knowledge the foregoing information is true and complete without evasion or misrepresentation. I understand that if it is later found otherwise, it is sucient cause for rejection or dismissal. If my
application for admission is approved, I agree to abide by the present and future rules and regulations, both academic and nonacademic, and the scholastic standards of the appropriate institution, its colleges, schools, departments
and institutes, including but not limited to those rules, regulations and standards stated in both the undergraduate and graduate catalogs. I further acknowledge that if I fail to adhere to these regulations or meet these requirements, my
registration may be canceled.
Applicant’s complete legal signature Date
Montana State University Billings has a policy of nondiscrimination in employment practices and in admissions, access to and conduct of educational programs and activities pursuant to title VII of the Civil Rights Act, Title IX
of the Education Amendments, Section 504 of the Rehabilitation Act, Executive Order 11246 as amended, Vietnam era and Disabled Veterans Act, as amended, and the Montana State Human Rights Act. Discrimination is
prohibited on the basis of race, sex, color, national origin, religion, age, disability, or marital status. Any student, employee, applicant for admission or employment may le a discrimination grievance. Inquiries or grievances
should be directed to the Human Resources/EEO-AA Director in McMullen Hall Room 310, phone (406)657-2278. For more detailed information, please refer to: http://www.msubillings.edu/geninfo/upolicies.htm
4. Has he/she led a Montana state income tax return? Yes No
as a part-year resident as a full-year resident
List the last three years Montana income taxes have been led: , ,
5. Date of his/her Montana voter registration (mo/day/yr)
6. Does he/she have a current Montana driver’s license? Yes No
Current Issue date (mo/day/yr) Is this a renewal? Yes No
7. Date of his/her current Montana vehicle registration (mo/day/yr)
8. What is his/her employment status? (check all that apply)
full-time part-time retired unemployed seasonal permanent
Name and address of employer
Date of start of employment
E. Please ll in table below with information about yourself for the past two years:
Employment Schools AttendedPlace of Residence
Dates
From
To
City College at
Montana State University Billings
3803 Central Ave.
Billings, MT 59102
800-565-MSUB, ext. 3007
406-247-3007
citycollege.msubillings.edu
ccadmissions@msubillings.edu
Sign up for information, apply for admission or schedule your
campus visit today!
msubillings.edu/future • (406) 247-3007
To access the annual campus crime report, please visit:
msubillings.edu/security
To access consumer information, please visit:
msubillings.edu/naid/Consumer_Information.htm
Montana State University Billings has a policy of nondiscrimination in
employment practices and in admissions, access to and conduct of
educational programs and activities pursuant to title VII of the Civil
Rights Act, Title IX of the Education Amendments, Section 504 of the
Rehabilitation Act, Executive Order 11246 as amended, Vietnam era
and Disabled Veterans Act, as amended, and the Montana State
Human Rights Act. Discrimination is prohibited on the basis of race,
sex, color, national origin, religion, age, disability, or marital status. Any
student, employee, applicant for admission or employment may le a
discrimination grievance. Inquiries or grievances should be directed to
the Human Resources/EEO-AA Director in McMullen Hall Room 310,
phone (406)657-2278. For more detailed information, please refer
to: http://www.msubillings.edu/geninfo/upolicies.htm
If you have a disability that you wish to bring to the attention of the
institution to which you seek admittance, you may do so, before or
after admission, by submitting a request for accommodation to either
the Disability Support Services oce or the Oce of Admissions and
Records. Applicants who need an alternative accessible format of this
application may request it from either of the above noted oces. All
requests regarding disability will be condential and will not be used as
a factor in granting or denying admission. Disability Support
Services is located in the College of Education building, room 135
and can be contacted at 657-2283/406-545-2518 (VP) or
tcarey@msubillings.edu.
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