Fillable Admissions Application College-form Admissions Application-College.pmd

Fill Online, Printable, Fillable, Blank Admissions Application College-form Admissions Application-College.pmd Form

Use Fill to complete blank online BLUEGRASS COMMUNITY AND TECHNICAL COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Admissions Application College-form Admissions Application-College.pmd

On average this form takes 14 minutes to complete

The Admissions Application College-form Admissions Application-College.pmd form is 2 pages long and contains:

  • 1 signature
  • 34 check-boxes
  • 36 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Bluegrass Community and Technical College

BROWSE BLUEGRASS COMMUNITY AND TECHNICAL COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
APPLICATION
for Admission
Please Print or TypePlease Print or Type
Please Print or TypePlease Print or Type
Please Print or Type
Name ______________________________________________________________________________________________________
First Middle Last Preferred Name
Address _________________________________________________________________________________________________
_________________________________________________________________________________________________
City County State Zip Code
Home Phone __________________________________________ Work or Cell Phone _____________________________________
Social Security Number ___________________________ Date of Birth ____________________ Gender F Male F Female
Month Day Year
Citizenship Status US Citizen F Ye s F No
If not a US citizen, what is your Visa Type? ___________________________ *What is your country of origin? _________________________
If not a US citizen, are you a permanent resident alien of the U.S.?
F Ye s F No Resident Alien Number ____________________________
(attach a copy of front and back of green card)
Foreign Address _______________________________________________________________________________________________________
*Primary Race/Ethnicity F Black, Non-Hispanic F American Indian or Alaskan Native F Asian or Pacific Islander
F Hispanic F White, Non-Hispanic F Other
Military Status F Active Military F National Guard Will you be receiving veteran’s benefits? Yes ____ No _____
F Active Reservist F Inactive Reservist
Please list all the names that you have used on previous educational records. _____________________________________________
__________________________________________________________________________________________________________
Starting Term F Summer F Fall F Spring _____Year
Program of Study ____________________________________________________________________________________________
Academic Plan Code: __________________________________ Academic Plan Name ___________________________________
[Enter the Academic Plans and Codes that are provided by the college with application or from their website.]
Admit Status
F First-Time Student F Readmit (attended KCTCS previously)
F High School (currently attending High School) F First-Time Transfer (Are you eligible to return to your
F First-Time Visiting Student former college?) F yes F no
Visiting students should bring permission letter Transcripts from all previously attended institutions are required
from their college. before applicant can be admitted.
High School Attended ________________________________________________________________________________________
(If you earned a GED enter GED for High School.) High School Name City State/County
High School Graduation Date _____________________________ or GED Completion Date ________________________________
Other Postsecondary institutions attended and Dates: (An official transcript from each institution listed is required for admission.)
College City State Dates Attended
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Residency Status F Kentucky Have you lived in Kentucky for the last 12 months? F yes F no
Have you received financial support from an individual
outside of Kentucky during the last 12 months? F yes F no
Does either parent live in Kentucky? F yes F no
F Non-Kentucky How long have you been living in your non-Kentucky county? ______________________
U
nless otherwise indicated, all information on this form must be complete and accurate. Withholding or providing false information may make you
ineligible for admission or enrollment. You will not be officially admitted to this college until all required credentials are received by this
Admissions Office. If you do not enroll, application materials will be retained on file for one year.
A
lthough there is not an application fee (except for Lexington Community College), upon signing this you acknowledge responsibility for all
financial obligations you incur if you enroll as a student in the Kentucky Community and Technical College System, including any costs
associated with the collection of your account.
Date ________________________ Signature ______________________________________________________________________
* Optional information requested for reporting purposes and will not be used in an admission decision.
Revised January 2005
Emp I.D.________________________
Date Entered ____________________
Advisor ________________________
Kentucky Community and Technical College System
click to sign
signature
click to edit
Program Goals
1. Which statement below reflects YOUR CURRENT
GOAL?
a To take a few courses but NOT earn a
Degree, Diploma or Certificate
b To complete an Associate Degree, Diploma
or Certificate
c To complete an Associate degree AND go on
to earn a four-year Bachelor’s Degree
d To take a few courses then TRANSFER to a
University
e I am uncertain about completing a Degree,
Diploma or Certificate
Enrollment Intent
2. I plan to (select one):
a Enroll for only this semester
b Enroll for this semester AND the next
semester
c Enroll every semester until I reach my goal
d Unsure about future enrollment
Access to Computer Technology
3. Do you have access to a personal computer,
either at home or at work, that you can use for
school work?
aYes
bNo
4. If yes, do you have access to the Internet from
that computer with e-mail access?
aYes
bNo
Employment Plans
5. While attending college, I plan to work:
a Not at all
b 1 - 20 hours per week
c 21 - 39 hours per week
d 40 hours per week
e More than 40 hours per week
Goals in Attending College
Below are goals some people give for going to college.
Please indicate if these goals are very important,
somewhat important or not important in your decision
to attend college.
6. To increase my general knowledge and understand-
ing of the world.
a Very Important
b Somewhat Important
c Not Important
7. To decide on a career goal.
a Very Important
b Somewhat Important
c Not Important
8. To develop or improve skills required in my current
job.
a Very Important
b Somewhat Important
c Not Important
9. To help me obtain a raise or promotion.
a Very Important
b Somewhat Important
c Not Important
10. To help prepare for a new career.
a Very Important
b Somewhat Important
c Not Important
11. To be with others who want to learn.
a Very Important
b Somewhat Important
c Not Important
EE
EE
E
NTERINGNTERING
NTERINGNTERING
NTERING
S S
S S
S
TUDENTTUDENT
TUDENTTUDENT
TUDENT
S S
S S
S
URVEYURVEY
URVEYURVEY
URVEY
KCTCS wants to help you achieve your educational goals. Your answers to the questions below will help us understand the background and needs
of our students. If you received a General Purpose Answer Sheet with your application, please enter your Social Security Number (SSN) in the
appropriate boxes on this form and use it to record your answers to the following questions. If you do not have a General Purpose Answer Sheet,
please enter your SSN above in the space provided and darken the circles next to responses that best represents your answers to each of the
following questions on this sheet.
YOUR ANSWERS TO THESE QUESTIONS ARE COMPLETELY CONFIDENTIAL AND WILL NOT AFFECT THE AWARD OF FINANCIAL AID OR
ACCEPTANCE TO THE COLLEGE. YOUR ADMISSIONS FORM WILL NOT BE COMPLETE UNTIL YOU COMPLETE THIS QUESTIONNAIRE.
12. To increase my self-confidence.
a Very Important
b Somewhat Important
c Not Important
13. To become more self-reliant.
a Very Important
b Somewhat Important
c Not Important
14. To improve my academic skills before going to a
large University.
a Very Important
b Somewhat Important
c Not Important
Reasons for Attending this College
Please indicate whether any of the following reasons
were very important, somewhat important or not
important in your decision to attend this community or
technical college.
15. Costs less than other colleges.
a Very Important
b Somewhat Important
c Not Important
16. I could not leave the area due to family
obligations.
a Very Important
b Somewhat Important
c Not Important
17. I can keep my job and still go to college.
a Very Important
b Somewhat Important
c Not Important
18. My grades were too low to get into another college
or University.
a Very Important
b Somewhat Important
c Not Important
19. This college offers the courses I want.
a Very Important
b Somewhat Important
c Not Important
20. This college has a reputation for good teaching/
training.
a Very Important
b Somewhat Important
c Not Important
21. Classes are small and more personal.
a Very Important
b Somewhat Important
c Not Important
22. This college is close to my home.
a Very Important
b Somewhat Important
c Not Important
23. My family wanted me to come here.
a Very Important
b Somewhat Important
c Not Important
24. I can take courses at night.
a Very Important
b Somewhat Important
c Not Important
25. I can take courses on weekends.
a Very Important
b Somewhat Important
c Not Important
26. If there had not been a Community or Technical
College in the area, I probably would (check one):
a Not attend college at all
b Go to one of the state Universities.
c Go to a private college
d Go to a private technical school
e Go to an out-of-state college or university
Parents and Family College Experience
27. Check any statement which is true for your family
or parents.
a I am the first person in my immediate family
to go to college.
b One or both of my parents or guardians went
to college but did not earn a degree.
c One or both of my parents or guardians
earned an associate degree from a
community college or junior college.
d One or both of my parents or guardians
earned a Bachelor’s degree from a college or
university.
Financial Information
28. What is your total annual income?
a less than $10,000
b $10,000 - $14,999
c $15,000 - $19,999
d $20,000 - $24,999
e more than $25,000
29. What is your total family household income?
a less than $10,000
b $10,000 - $14,999
c $15,000 - $19,999
d $20,000 - $24,999
e more than $25,000
30. Which of the following best describes the
household in which you currently reside? Are you
living. . .
a with parents or grandparents
b with spouse
c with spouse and children
d with children
e other (Skip to Question 32)
31. OTHER THAN YOURSELF, how many people rely
on you for ALL or MOST of their financial support?
a0
b1
c2
d3
e 4 or more
32. How many people live in your household?
a0
b1
c2
d3
e 4 or more
Please indicate the major source through which you
learned about this College.
33. Which of the following media:
a Internet
b Television
c Radio
d Newspaper
e Brochure
34. Which of the following people:
a Faculty or staff member
b High school counselor or instructor
c Parents
d Friend or other relative
e Coworker or supervisor
Enter your Social Security Number (SSN)
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Admissions Application College-form Admissions Application-College.pmd

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 February 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document