Fillable Application For Admission (Central Georgia Technical College)

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Application For Admission (Central Georgia Technical College)

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a p p l i c a t i o n f o r
ADMISSION
Crawford County Center
640 GA Highway 128
Roberta, Georgia 31078
(478) 836-6001
Hawkinsville Workforce
Development Center
243 Warner Robins Highway
Hawkinsville, Georgia 31036
(478) 783-3017
Monroe County Center
433 Highway 41 South
Forsyth, Georgia 31029
(478) 992-2717
Peach County Workforce
Development Center
425 James E. Khoury Drive
Fort Valley, Georgia 31030
(478) 218-3739
Putnam County Center
580 James Marshall Bypass
Eatonton, Georgia 31024
(706) 923-5000
Warner Robins Campus
80 Cohen Walker Drive
Warner Robins, Georgia 31088
(478) 988-6800
Macon Campus
3300 Macon Tech Drive
Macon, Georgia 31206
(478) 757-3400
Milledgeville Campus
54 Highway 22 West
Milledgeville, Georgia 31061
(478) 445-2300
Complete and submit all admissions forms and documents
• Application for Admission
• Release of Student Information form
• Student Agreement form
Transient students must include a transient letter with application.
International students must include a copy of I-94, VISA, and passport.
Provide a copy of your current driver’s license or other accepted
document to verify your lawful presence in the United States
and be considered for in-state tuition. You must submit this
documentation to be considered for in-state tuition regardless of
how long you have actually lived in Georgia
*
. Accepted documents
include:
• Current driver’s license issued by the state of Georgia after January 1,
2008
• Current ID issued by the state of Georgia after January 1, 2008
• Current driver’s license or ID issued by a state that veries
immigration status and only issues to persons lawfully present in the
United States:
Alabama: Issued after August 1, 2000
Florida: Issued after January 1, 2010
South Carolina: Issued after November 1, 2008
Tennessee: Issued after May 29, 2004
• Certied U.S. birth certicate showing the student was born in the
U.S. or a U.S. territory. A photocopy is not acceptable.
• Approved, completed FAFSA for the current nancial aid year
• Current, valid Permanent Resident Card (USCIS form 1-151 or 1-551)
• Current, valid military identication card for active duty soldiers or
veterans
• U.S. Certicate of Birth Abroad issued by the Department of State
(DS-1350) or a Consular Report of Birth Abroad (FS-240)
• Current U.S. Passport
• U.S. Certicate of Citizenship (USCIS form N-560 or N-561)
• U.S. Certicate of Naturalization (USCIS form N-550 or N-570)
*Students must also meet the in-state tuition requirements as outlined in TCSG
Board Policy and Procedure V.B.3 to warrant an in-state classication. Students
that are initially classied as out-of-state and successfully petition to have their
residency changed to in-state also have to meet the verication requirement.
Pay the non-refundable application fee of $25. Make checks
payable to CGTC; to pay by credit card, contact the cashier at
(478) 218-3387.
Request an OFFICIAL high school or high school equivalency
transcript. Home-schooled students must also submit a copy of
Declaration of Intent to Home School as led with the local Board
of Education. An ocial copy is one received in a sealed envelope from the
institution. Certicates of Attendance or special education diplomas are not
recognized for admission purposes.
Request an OFFICIAL transcript from all colleges attended. Some
classes might transfer from your previous college to CGTC.
Take the ACCUPLACER® placement test at CGTC or provide a copy
of COMPASS, ASSET, SAT or ACT scores (if taken within the past
ve years). Students with disabilities requiring testing accommodations
must contact the Special Populations Disability Director in Warner Robins at
(478) 218-3229 or in Macon at (478) 476-5137 prior to their assigned testing
time. Transfer students may exempt testing by submitting an ocial transcript
from their prior college documenting completion of program-level math and
English course work.
n e w s t u d e n t
c h e c k l i s t
To complete the FAFSA
*
:
Visit www.fafsa.ed.gov and click the Start A New FAFSA button.
If you do not have a FSA ID (username and password), click the
button next to Enter the student’s information.
Complete the FAFSA. Include CGTC’s school code: 005763.
You will need your income information for the particular year required. If you
are married on the day you apply, you must list your spouse’s income. If you
are considered a dependent your parent(s) must list their income. Information
about dependency status, as well as FAFSA instructions, are available online at
www.centralgatech.edu/nancialaid.
Next steps:
You will receive a Student Aid Report (SAR) via mail or email. Review
this to make sure that your information is complete and correct.
Notify CGTC’s Financial Aid Oce if you will be receiving any type
of education assistance other than federal or state student aid. You
must also report if you received nancial aid assistance at another
college.
Check your student account in BannerWeb, your CGTC email
account, and the FAFSA website for information regarding the
status of your nancial aid application. Information about book
voucher authorizations, additional documents needed from you,
and other important nancial aid information is also available
using these resources. Check your postal mail for award notices.
Turn in any required documents to the Financial Aid Oce as soon
as possible. You cannot receive nancial aid until you provide all
requested documentation. Allow 5-7 days for processing time.
Contact the Financial Aid Oce at (478) 988-6800 if you have any
questions regarding your application or nancial aid.
f i n a n c i a l a i d
c h e c k l i s t
Remember:
• If you decide to change your program of study or drop/
withdraw from classes, contact a nancial aid specialist to
nd out how these changes will aect your nancial aid.
• Financial aid will not pay for classes that are not required
for a student’s program of study.
• Students do not have to be full time to receive nancial aid
(Pell/HOPE); the amount of aid is based on the number of
hours in which you are enrolled.
• Students must be enrolled in at least six hours to apply for
a Federal Direct Loan.
All applicants must be least 16 years of age.
For additional information, please visit
www.centralgatech.edu/admissions.
CGTC will communicate with you by email, phone, and postal
mail. Check your college and personal email accounts frequently,
and keep your phone and mailing address up-to-date.
Financial aid to help pay for tuition, fees, and other educational costs
is available for qualied students. To apply for nancial aid, you must
complete the Free Application for Federal Student Aid (FAFSA) and
submit all required documents before enrolling and taking classes.
If you are a Move on When Ready (MOWR) student, stop here and
request a MOWR application from the Oce of Admissions.
RESIDENCY INFORMATION
Are you a Georgia resident?
Yes No
If yes, what is your date of residency?
Use your date of birth if you have lived in Georgia your entire life.
Are you requesting the in-state tuition rate?
Yes No
Home Phone Cell (Voice) EmailCell (Text)
If you (or your parent/guardian, if you are a dependent) have lived
in Georgia for 12 consecutive months or more, you may request the
in-state tuition rate, which is less than out-of-state or international
tuition rates. You will automatically be charged the out-of-state
tuition rate unless you request the in-state tuition rate and provide
verication of lawful presence as a Georgia resident.
Date of Birth:
STATISTICAL INFORMATION
Gender: Male Female
Race/Ethnicity Description Denitions
Hispanic/Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or
other Spanish culture or origin, regardless of race
American Indian or Alaskan Native: A person having origins in any of the original
peoples of North and South American (including Central America) and who maintains a
tribal aliation or community attachment
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia,
or the Indian subcontinent including, for example Cambodia, China, India, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
Black or African American: A person having origins in any of the black racial groups of Africa
Native Hawaiian or Other Pacic Islander: A person having origins in any of the original
people of Hawaii, Guam, Samoa, or other Pacic Island
White: A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa
Race (select one or more):
American Indian/Alaskan Native
Asian
Black/African American
Native Hawaiian/Pacic Islander
White
/ /
Are you currently unemployed?
Yes No
Are you currently underemployed?
You are considered underemployed if you are currently
employed in a temporary job; are available for full-time work, but have had to settle for a part-
time work schedule; and/or have been negatively aected by downsizing.
Yes No
Are you Hispanic or Latino?
Yes No
Social Security Number:
PERSONAL INFORMATION (Please Print Clearly)
Last Name:
First Name:
Middle Name:
All Previous Names:
Street Address: Apt/Lot:
City:
County:
State:
ZIP Code:
Home Phone:
Cell Phone:
Email:
Emergency Contact:
Phone:
Relationship to you:
- -
--
( ) ( )
-
( )
First Generation Student:
Yes No
Did your father graduate from college?
I don’t know
Yes No
Did your mother graduate from college?
I don’t know
Employment Status:
What is the best way for us to contact you?
Select One:
United States Citizen
Permanent Resident Alien
Non-Resident Alien (international tuition rates will apply)
Select One:
Yes No
Have they lived in that state for 12 consecutive months?
I am under 24 years old and my parents/guardians claimed me on their last tax return
What is your parents’/guardians’ legal state of residence?
Yes NoHave you lived in that state for 12 consecutive months?
I am 24 years old or older
What is your legal state of residence?
Yes No
Have you lived in that state for 12 consecutive months?
I am under 24 years old and no one claimed me on their last tax return
What is your legal state of residence?
Undocumented Alien (international tuition rates will apply)
a p p l i c a t i o n f o r
ADMISSION
Page 1
For oce use only: ID#
SIGNATURE
I hereby consent to the release of directory information, as dened in the school catalog/handbook. I give permission for my likeness, voice, or comments to be used in any
promotional item on behalf of CGTC or TCSG. I also give CGTC permission to contact me at all telephone numbers provided, including text message and/or voice. To opt out of
the release of directory information, please request a Release of Student Information form from the Oce of Admissions at admissionsoce@centralgatech.edu. All documents
submitted become and remain the property of CGTC and will not be returned to the applicant, duplicated, or transferred to another institution.
Pursuant to O.C.G.A. 16-10-20, it is a felony to make a false statement on any state document. I certify that the information contained in this application is true and correct. I
understand that making a false statement on, misrepresenting information on, or omitting information from this application will be sucient cause for denial or dismissal from the
college. If admitted as a student at CGTC, I agree to abide by the rules and regulations of the College regarding conduct and other obligations.
Students with disabilities requesting special assistance must contact the Special Populations Disability Director at (478) 218-3229 (Warner Robins) or (478) 476-5137 (Macon).
Signature: Date:
As set forth in its student catalog, Central Georgia Technical College (CGTC) does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political aliation or belief, genetic information,
veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). The following person(s) has been designated to handle inquiries regarding the non-discrimination policies: The Title IX/Section
504/ADA Coordinator for CGTC nondiscrimination policies is Cathy Johnson, Executive Director of Conduct, Appeals & Compliance; Room A-136, 80 Cohen Walker Drive, Warner Robins, GA 31088; Phone: (478) 218-3309; Fax: (478) 471-5197;
Email: cajohnson@centralgatech.edu.
/ /
PREVIOUS COLLEGE INFORMATION
List all colleges attended and dates attended. Request an ocial transcript from
each college that you attended to nd out if your classes will transfer to CGTC.
Name of College
List most recently attended rst & date last attended
City State Dates Attended Degree Earned
(i.e., A.A., B.A., B.S.)
HIGH SCHOOL INFORMATION
If you have not graduated from high school, have you earned
a GED® or high school equivalency?
If yes, enter the date you earned it:
Yes No
Name of high school:
City: State:
Have you graduated from high school?
Yes No
If yes, what year did you graduate?
ENTRANCE DATA
When do you plan to start?
Type of Admissions:
Beginning student (rst time college student)
Transfer student (previously enrolled at another college)
Former CGTC or MGTC student What was the last year you attended?
International student (non-permanent resident)
Transient (enrolling at CGTC to complete course requirements for home college)
Special admit (no credit or grade received - no nancial aid available)
What campus/center do you plan to attend?
Warner Robins
Macon
Milledgeville
Crawford County
Monroe County
Hawkinsville WDC
Putnam County
Program of Study/Major:
Check one: Associate of Applied Science Degree Diploma Technical Certicate
Program Name:
Specialization (if applicable):
Yes No
Are you applying because of Georgia’s Go Back/Move Ahead
program (www.gobackmoveahead.org)?
Peach County
GA VECTR Center
Fall
Spring
Summer
Full Semester
Mini-mester Session I
Mini-mester Session II
Semester Session
Online
Submit the Application for Admission with the $25 non-refundable application fee.
Submit an ocial high school or high school equivalency transcript.
Submit ocial transcript from previous college(s) attended (if transferring from an accredited college).
Take the required placement test at CGTC or submit acceptable ASSET, COMPASS, ACCUPLACER®, ACT, or SAT scores taken within the last 5 years.
Apply for nancial aid online at www.fafsa.ed.gov to assist in the cost of tuition, fees and other educational costs.
STOP! YOUR APPLICATION IS NOT COMPLETE UNTIL YOU:
MILITARY
Are you currently active duty military?
Yes No
Are you an active duty dependent or spouse?
Yes No
Are you a military veteran?
Yes No
Select Branch of Service:
Air Force
Air Force Reserve
Army
Army Reserve
Coast Guard
Coast Guard Reserve
Navy
Navy Reserve
Marines
Marine Reserve
Air National Guard
Army National Guard
Page 2Visit www.centralgatech.edu for more information.
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Completed 25 July 2020

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