Student Achievement & Success Program Application
I am interested in enrolling in . I understand this is a program designed by Anne Arundel Community
College to monitor and assist students enrolled. I realize my work and determination with this support will
allow me to reach my academic and career goals.
Personal Data (print clearly):
Name _____________________________________________________ Date ______________
Address _______________________________________________________________________
City____________________________________________ State_______ Zip Code____________
Phone (h) ______________________ (w) ________________________ (c) _______________________
E-Mail _________________________________________ AACC Student ID# ____________________
Previous Institution:
Name: ____________________________________ Graduation date: __________________
Date of Birth ___________________ Gender___________ Ethnicity (Optional) _________________
First language, if other than English ____________________________
Has any or your parents received a bachelors degree? ___Yes ___No
Military Service: {Active, Reserve, Dependent, Veteran}
Educational Information: (√) CHECK ALL THAT APPLY
I have completed the Accuplacer Placement Test at Anne Arundel Community College or submitted my
SAT/ACT scores.
I am currently enrolled in Anne Arundel Community College for ____ semester hours for fall 2018.
I have already completed the Free Application for Federal Student Aid (FAFSA)
I began attending AACC during the semester.
Current Academic Goal:
Degree {Associate Degree, Transfer, Certificate, Undecided} Major: _____________________________
Preferred Method to communicate with you: (√) CHECK ALL THAT APPLY
____ My AACC Email
____ Personal Email
____ Home Phone
____ Cell Phone
I learned about the SASP Program from:
A high school guidance counselor
An AACC academic advisor
An AACC faculty/professor
SASP Staff Member
Another student
A brochure
Summer Bridge
Please send the completed form to:
Anne Arundel Community College
Attn: SASP
101 College Parkway (LBRY 129)
Arnold, MD 21012