EDUCATION HISTORY
Name of High School Diploma Yes No
City/State Date of Graduation / /
If you did not graduate from High School, did you receive a GED? Yes No (If yes, complete the information below)
Where test was taken: Mother’s Maiden Name:
Date taken: / / Institution Name City/State
If you have any previous training above the high school level, whether college or vocational, please list names of the schools attended and courses studied. This information is required whether you
believe it applies to courses offered at Platt College. All transcripts submitted must be OFFICIAL, i.e., sent from the institution directly to Platt College.
Are you currently attending, or have you previously attended, a college or university? Yes No
Name of School Dates Attended_________to_________ Degree Diploma
Name of School Dates Attended_________to_________ Degree Diploma
Name of School Dates Attended_________to_________ Degree Diploma
Name of School Dates Attended_________to_________ Degree Diploma
Name of School Dates Attended_________to_________ Degree Diploma
MILITARY EXPERIENCE
Branch: Active Veteran Dependent
Veterans should be aware that the G.I. Bill prohibits duplication of training a veteran has received elsewhere, and prohibits enrollment in a course of training leading to an educational, professional or
vocational objective for which they are already qualified.
FATHER/GUARDIAN INFORMATION MOTHER/GUARDIAN INFORMATION
Name Name
Address Address
City/State/Country City/State/Country
ZIP/Postal Code ZIP/Postal Code
E-mail E-mail
Home Phone Work Phone Home Phone Work Phone
Father’s Employer Mother’s employer
Position Position
FINANCIAL INFORMATION
Name of person to whom bills should be sent:
Address
City/State/Country ZIP/Postal Code
Telephone Fax E-mail
REFERENCES (Please list names and phone numbers of three references)
Name Relationship Telephone
Name Relationship Telephone
Name Relationship Telephone
SIGNATURE
X:
Signature of applicant (If admitted, I agree to abide by the rules and regulations of Platt College.) I do hereby certify that all statements made by me in this application are true and correct to the
best of my knowledge. I understand that in the event that I have knowingly and willingly made any false statements my application for admission may be denied.
Mail application to: Admissions Department For more information contact: Admission Department
Platt College San Diego 619.265.0107 • Toll-free 866.752.8826
6250 El Cajon Blvd.
San Diego, CA 92115 www.platt.edu
Platt College reserves the right to contact any or all of the individuals listed on this form. Platt College does not discriminate on the basis of race, color, national origin, sex, handicap, or age in employment
admissions, or any educational programs or activities.
6/1/20
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