Honors Program
Spring 2021 Program Application
Admission to the Honors Program is selective and space is limited. This application does not guarantee acceptance.
The Spring 2021 application deadline is January 14, 2021.
PLEASE PRINT CLEARLY USING BLUE OR BLACK INK
APPLICANT’S LEGAL NAME (Last) (First) (Middle)
BANNER ID (if you have one)
BIRTH DATE (Month/Day/Year)
□ Yes □
MxCC New S tudent
No
Application must also b e
on file.
ADDRESS (No. and Street) (Apt. #) (City or Town) (State) (Zip Code)
HOME TELEPHONE (Area Code)
COMMUNITY COLLEGE E-MAIL ADDRESS (all emails will be sent to your new community college email address. You can look up your new
email address in myCommNet).
APPLICATION CHECKLIST
Requirement
Completed?
English Composition (ENG*101)
Grade of “B+” or higher by the application deadline.
Eligible for or completion of Algebra (MAT*137) or higher
Writing sample from ENG*101 or another course
Must demonstrate quality academic writing.
At least one letter of recommendation from a professor
Minimum GPA of 3.0 in all college coursework
Official copy of all college or university transcripts
If you have completed courses at Middlesex Community College you do not need to submit
your MxCC transcript.
I have provided true, correct, and complete information. I realize that any misleading information on
this application may be cause for dismissal.
Signature: ________________________________ Date: _______________
Please submit complete applications and address questions to:
Andrea Levy, Ph.D.
Emily Canto
Professor of Psychology
Counselor
alevy@mxcc.edu
ecanto@mxcc.edu
860.343.5815
860.343.5826
