Personal Information:
Last Name (Family/Surname)
First Name (Given)
Date of Birth (Month, Day, Year)
Country of Citizenship
Email Address
Current Mailing Address:
Number and Street
Postal Code
Educational Information:
Have you applied for admission or are you currently a student at Indian Hills Community College? Yes No
If yes, what will be or was your first semester of enrollment at Indian Hills? Year
If no, please move ahead with this process by submitting the Indian Hills Admission Application
What school/college are you interested in?
California State University, Northridge
Coastal Carolina University
Flagler College
Iowa Wesleyan University
Mount Mercy University
Northwest Missouri State University
Simpson College
University of Minnesota, Crookston
University of Northern Iowa
University of South Florida
Washington State University
Wayne State College
Western Kentucky University
William Penn University
University of Don Bosco
Pella Christian High School
By answering yes to the below you state that you are interested in being a part of the Indian Hills Community College Transfer
Pathways Program and give Indian Hills and the selected College above permission to share your personal data and educational
documents with each other.
Yes, I agree to these terms. No, I do not agree to these terms.
Submit Application to:
Karla McCollum, Director of International Aairs
Indian Hills Community College
1-800-726-2585, ext. 5266
It is the policy of Indian Hills Community College not to discriminate on the basis of race, color, national origin, sex, disability, age (employment), sexual orientation, gender identity, creed, religion, and actual or potential parental, family, or marital status in its programs,
activities, or employment practices as required by the Iowa Code §§216.6 and 216.9, Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d and 2000e), the Equal Pay Act of 1973 (29 U.S.C. § 206, et seq.), Title IX (Educational Amendments, 20 U.S.C §§ 1681
– 1688), Section 504 (Rehabilitation Act of 1973, 29 U.S.C. § 794), and Title II of the Americans with Disabilities Act (42 U.S.C. § 12101, et seq.).
If you have questions or complaints related to compliance with this policy, please contact Kristen Parks, Director of Human Resources/Equity Coordinator, 525 Grandview Ave, Ottumwa, IA 52501, 683-5108; Chris Bowser, Executive Dean, Student Services, (students),
683-5159; Darlas Shockley, Executive Dean , Arts & Sciences (students with disabilities), 683-5174; U.S. Department of Education, Citigroup Center, 500 W. Madison, Suite 1475, Chicago, IL 60661, phone number 312/730-1560, fax 312/730- 1576.