Fillable - Application Fall 2020 Rev Oct 19 (Middlesex Community College)

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- Application Fall 2020 Rev Oct 19 (Middlesex Community College)

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Veterinary Technology
FALL 2020 PROGRAM APPLICATION
STUDENT INFORMATION
Please print clearly using black or blue ink
APPLICANT’S LEGAL NAME (Last)
(First)
BANNER ID NUMBER (if known)
SOCIAL SECURITY NUMBER
BIRTH DATE (Month/Day/Year)
CURRENT MxCC STUDENT?
r Yes r No
ADDRESS (No. and Street) (Apt. #) (City) (State) (Zip)
HOME TELEPHONE (Area Code)
CELL (Area Code)
COMMUNITY COLLEGE EMAIL ADDRESS (All email will be sent to your community college email address. You can look up your address in myCommNet or by using
the NetID Lookup Utility at http://www.ct.edu/netid)
PERSONAL EMAIL ADDRESS
Grade & Semester Earned
English Composition (ENG*101)
With a grade of “C” or better, completed prior to the application deadline.
Competency in Intermediate Algebra
MAT*137, equivalent or higher with a grade of “C” or better; Accuplacer or SAT/ACT
placement above MAT*137.
General Biology I (BIO*121)
With a grade of “C” or better, taken within 5 years prior to program admission.
Concepts of Chemistry (CHE*111)
With a grade of “C” or better, taken within 5 years prior to program admission.
Mid-Term Grade Report (For all spring semester courses)
r Check when complete
Official copy of all college or university transcripts and SAT/ACT scores (if any)
r Check when complete
SUPPLEMENTAL REQUIREMENTS
Two Letters of Recommendation (Typed)
r Check when complete
Personal Statement/Essay
r Check when complete
“Five years prior” is defined as having completed the course between December 2014 (fall 2014 semester) and the application deadline. If you
took BIO*121 and/or CHE*111 more than 5 years ago and wish to have these grades included in your application, please submit a written
statement requesting a waiver of this requirement. For example, the Admissions Committee will consider grades for advanced coursework
beyond BIO*121 and/or CHE*111, taken within the past 5 years.
Admission to the Veterinary Technology Program is selective and space is limited. This application does not guarantee acceptance.
Application deadline is April 1, 2020
Submit all materials to the Office of Enrollment Services.
No late submissions will be accepted.
Office of Enrollment Services
100 Training Hill Road
Middletown, CT 06457-4889
T: 860-343-5719 F: 860-344-3055!
ACADEMIC INFORMATION
What is the highest degree that you have earned (check one):
r No degree r Associate Degree r Baccalaureate Degree r Master’s Degree r Doctoral Degree
List ALL colleges and universities attended. Failure to submit official transcripts from all previously attended
colleges and universities (including CT Community Colleges) by
April 1, 2020
will make you ineligible for the
2020-2021 academic year.
Name of School & Address
(City, State & Country if outside the U.S.)
Dates Attended
Degrees/Certifications
Earned
1.
2.
3.
4.
5.
If you have attended additional colleges, please list them on a separate sheet of paper and submit along with
your application. Students who have attended or are currently attending one of the twelve Connecticut
Community Colleges must submit community college transcripts from all previously attended Connecticut
Community Colleges.
No deadline extensions will be given to applicants who fail to submit required transcripts
from the CT Community College System by the application deadline.
All transcripts must be final transcripts. Students taking courses in the fall or winter semester prior to applying
must submit transcripts that include their fall and winter grades. All transcripts (including those with course
withdrawals, course failures, and remedial/developmental courses) must be submitted regardless of the age of
the transcripts and applicability to the Veterinary Technology Program. This includes any college credits earned
while in high school. A minimum 2.7 GPA is required for all courses that meet the admission and curriculum
requirements of the Veterinary Technology Program.
Students who have prior Veterinary Technology coursework that wish to transfer VET* credits to the program
must meet with the Program Coordinator prior to application submission to review course transfer eligibility.
SUBMISSION OF APPLICATION
I have provided true, correct, and complete information. I have read and I understand the information provided
in the application instructions and the application packet. I understand that I must submit all official supporting
documents to the Middlesex Community College Office of Enrollment Services by April 1, 2020 in order to be
considered for admission to the 2020-2021 Veterinary Technology Program. I realize that any misleading
information on this application may be cause for dismissal. I request the college forward to me at the email
address I have provided all correspondence, including personally identifiable information pertaining to me from
College records that is protected by FERPA.
Please check one:
r I agree to the
above statement.
r I do not agree to the
above statement.
Signature: Date:
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- Application Fall 2020 Rev Oct 19 (Middlesex Community College)

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Completed 29 July 2020

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