Stone Child College
8294 Upper Box Elder Road
Box Elder, MT 59521
(406) 395-4875 ext. 264
Fax: (406) 395-4836
Please print clearly, check all that apply. An incomplete application will not be processed.
Social Security Number:_____________________ Freshman: ____
Sophomore: ____
Transfer: ____
Last Name First Middle Initial
Mailing Address:____________________________________ City______________ County______State____ Zip Code________
Email address:________________________________________________
Home Phone: Other contact Phone: .
Male:____ Female:____ Single:____ Married____
Birth Date:____________ American Indian ___Yes___No Tribe:_________________________
Name Address Phone
Are you a United States citizen? ____Yes ____No
Semester you expect to enroll: ____Fall Spring Summer ____________Year
Have you completed your Financial Aid packet? Yes No
Which state are you a resident of? _________
What year and state did you last file taxes?_______
Have you ever been convicted of a felony? Yes___ No___
If you answered yes, what were you convicted for? ________________________
Please Note: Changes will not be saved, document must be printed after filling in own information and submitted to the Registrar.
Please Check One:
____ Please indicate last time you attended Stone Child College. Year graduated: _____(if a
prior graduate)
____ Ability to Benefit (No High School Diploma or GED Certificate)
Please circle highest grade completed: 1 2 3 4 5 6 7 8 9 10 11 12
Name of school attended: _________________________________________
____ High school graduate. Official HS transcripts must be on file.
High school name/location: _______________________________________
Year graduated:__________
____ GED Certification. Official GED must be on file.
Location City/State Obtained:____________________________________
Year earned:_____________
____ Other college credits earned and/or degrees earned:
Name of College
Dates Attended
# Credits Earned
Degree Earned
Application Process:
1. Student must have requested all transcripts from previous college, high school or GED program,
before registration for courses is allowed.
2. Student must have official Certificate of Indian Blood if enrolled in a U.S. federally recognized
Indian tribe.
3. Proof of immunization record showing student has received Measles, Mumps, Rubella 1 and 2
(MMR 1 an d MMR 2). Applies to student born after January 1,1957. If you claim immunization
exemption, please notify the Registrar/Admission’s Office for the proper immunization exemption
4. Student must take the ACT/COMPASS test prior to Registration for courses.
5. Application for Admission must be completed, signed, and dated. Incomplete Applications for
Admissions will be put on hold and will not be processed until completed by the student.
6. Conditional Admission is granted through Registrar/Admission’s Office Only.
I hereby apply for admissions at Stone Child College and agree to abide by the institution’s regulations,
policies and procedures. To the best of my knowledge all information provide on this application is true.
__________________________________________ _______________________________
Student Signature Date
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