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Instructions: This form is required if you have previously been admitted to Galveston College but have not attended for at least
one semester (not including summer semesters). If it has been a full year or more since your last date of attendance, then
you must fill out the complete application for admission.
By providing the number above, you certify this as your true and accurate Social Security Number
Gender
Male
Female
Date of Birth (MM/DD/YYYY)
Name (Legal name as it appears on your Social Security card)
Last First Middle Suffix
Other Names Used
Permanent Mailing Address
City
State
Zip
Current Residential Address
State
Zip
County
Time at Address
Less than 1 Year
1 year or more
Email Address
Home Phone Number
Cell Phone Number
Work Phone Number
Emergency Contact Name
Emergency Contact Number
Program of Choice (see back)
Anticipated Start Date at Galveston College
Fall
Spring
Summer I
Summer II Year
:
Educational Intent
Earn a Degree (2 year)
Earn a Certificate (<2 years)
Earn Credits for Transfer
Improve Job Skills
Personal Enrichment
Please list all colleges or universities attended since last attending Galveston College
Name of College
Location
Dates Attended
Hours/Degree Earned
I certify the information on this application is complete and correct and understand that the submission of false information is grounds for rejection of my application,
withdrawal of any offer of acceptance, cancellation of enrollment, and/or appropriate disciplinary action. I agree to notify the proper officials of any changes in the
above information.
It is the policy of Galveston College to provide equal opportunities without regard to age, race, color, religion, national origin, gender, disability, genetic information, or veteran status
Student ID Number
Social Security Number
Signature
Date
click to sign
signature
click to edit
An associate of arts/associate of science degree is a program of study requiring 60 credit hours for completion. This program normally satisfies the requirements for the
first two years of a four-year degree, which may be completed by the student upon transfer to a university. Programs of study for the Associate of Arts degree
parallel the first two years required for Bachelor of Arts and Bachelor of Science degrees at many senior colleges and universities.
AA/AS P
ROGRAMS
General Studies (AA)
Engineering, Mechanical (AS)
General Studies (AS)
English (AA)
Art (AA)
Health & Physical Education (AA)
Biology (AS)
Health Science - Clinical Lab Science (AS)
Biology/Pre-Professional Health (AS)
Health Science - Occupational Therapy (AS)
Business Administration (AS)
Health Science - Transfer Nursing (AS)
Chemistry (AS)
History (AA)
Computer Science (AS)
Mathematics (AS)
Criminal Justice (AA)
Physics (AS)
Drama (AA)
Political Science (AA)
Education - EC-6, Generalist (AS)
Psychology (AA)
Education - Middle School Level Mathematics (AS)
Psychology (AS)
Education - High School Level Mathematics (AS)
Sociology/Social Work (AA)
Engineering, Industrial (AS)
Speech Communications (AA)
An Associate of Applied Science Degree is awarded to students who have successfully completed an approved curriculum for a two year occupational program
and is usually sufficient for entrance into an occupational field.
AAS P
ROGRAMS
Cosmetology*
Medical Administration
Culinary Arts
Nuclear Medicine Technology*
Electrical/Electronics Technology
Nursing (ADN)*
Emergency Medical Services*
Radiation Therapy Technology*
EMT-P to ADN Transition*
Radiography*
Heating/Ventilation/Refrigeration/Air Cond.
Surgical Technology*
LVN to ADN Transition*
Welding Technology
A Certificate program is an intensive program of study requiring less than 60 credit hours for completion. These programs are normally designed to provide short-term
training necessary to develop entry-level job skills without requiring completion of an associate degree.
C
ERTIFICATE
P
ROGRAMS
Computerized Tomography*
Heating/Ventilation/Refrig/Air Cond - Advanced
Cosmetology*
Law Enforcement Academy*
Cosmetology Instructor*
Magnetic Resonance Imaging*
Culinary Arts
Medical Coding
Electrical/Electronics Technology: Basic
Medical Records Technician
Electrical/Electronics Technology: Intermediate
Radiation Therapy Technology*
Electrical/Electronics Technology: Advanced
Surgical Technology*
Emergency Med Services: Intermediate*
Vocational Nursing*
Emergency Med Services: Paramedic*
Welding Technology - Basic
Heating/Ventilation/Refrig/Air Cond - Basic
Welding Technology - Intermediate
Heating/Ventilation/Refrig/Air Cond - Intermediate
Welding Technology - Advanced
* Programs with an “*” are special admissions programs and require additional admission requirements for acceptance.
ASSOCIATE OF ARTS DEGREE PROGRAMS (AA)/(AS)
ASSOCIATE OF APPLIED SCIENCE DEGREE PROGRAMS (AAS)
CERTIFICATE PROGRAMS
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Instructions: This form is required if you have (Galveston College)

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Completed 27 July 2020

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