Admissions Office
Application to Defer Admissions
Complete this form, sign, date and mail to Manchester Community College, Admissions, Great Path, MS #12, P.O. Box 1046, Manchester, CT 06045-1046 or drop off at
Admissions office, SSC L156 or fax to 860-512-3221. For more information or questions, contact the Admissions office at 860-512-3210 or by email to ma-admissions@
manchestercc.edu.
STUDENT INFORMATION
First Name MI Last Name
Street Address Apt. #
City State Zip Code
Home Phone Cell Phone Email
Program of Study
REQUIRED
I give Manchester Community College permission to transfer my Admissions Application
From Semester/Year Originally Applied For Entrance To New Semester/Year Entrance Requested
Student Signature Date
January 2020/PR
Banner ID Number
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