Carroll Community College

Carroll Community College

http://www.carrollcc.edu

Enrollment Application

†* Fields marked with an asterisk and shown in red are required. Please verify that all required fields have been filled-in before submitting the form.

Personal Data

Legal Name:
Permanent Address:

Residency Status: In-County Out-of-County Out-of-State

It takes 90 days to establish residency in Carroll County and be eligible to pay tuition at the in county tuition rate if applicable.

Phone Numbers: -- --
Emergency Contact Information: --
This number is used by the college to contact someone else if you are incapacitated during an emergency. You may re-enter you home number, but we do not recommend using your personal cell number.
Social Security Number:

The submission of your Social Security Number (SSN) below is optional. You must provide your Social Security Number to apply for financial aid or receive the 1098T tax document used for educational tax deduction purposes. Your SSN will not be shared or used for any other purpose.

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Race/Ethnicity

Colleges and universities are asked by many, including federal and state governments and national surveys, to describe the racial and ethnic backgrounds of our students and employees. We ask that you answer both of the following questions:

Definitions of these terms are available online.

Yes †† No White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Email

Carroll Community College uses email addresses, as supplied by students, for official and confidential College communications. It is the studentís responsibility to confirm that the email address is correct.

Enrollment Year & Term

Academic Program/Intended Major

Students are required to be degree seeking in order to qualify for financial aid or veteran benefits. Please note that you are not eligible for financial aid if you are taking classes while still in high school or have already earned a bachelor's degree.

AAS and AS = Career Program (workforce entry after completion of this degree)
AA = intended transfer pattern to a four year school (must complete a bachelorís degree to work in this field)
AAT = guaranteed transfer to a four year teacher education program in Maryland
ASE = guaranteed transfer to a four year engineering program in Maryland
Letter = sequence of classes to designate skill set in specific area
Certificate = qualification in designated area

Admission Status:


Student planning to work toward an Associate Degree or Certificate who has a high school diploma or its recognized equivalent (i.e.,GED)


Student currently attending high school while taking courses part-time at Carroll, including public, private, and home schooled students; concurrently enrolled students; and students taking classes outside of regular high school hours


Student by-passing a semester of the 12th grade to attend Carroll Community College full-time (also called 8th semester waiver)


Student enrolled at another college or university taking Carroll courses to transfer back to the parent institution


Student taking coursework for personal enrichment (not seeking a degree or certificate) or over 18 years of age who does not have a high school diploma or its recognized equivalent

Citizenship:

*You may enroll without documentation, but you will be charged at the out-of-state rate. If you possess official documentation, please present your documentation for copying to the Admissions Office, to ensure that you are charged tuition appropriately.

High School Information:

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All Previous Colleges/Universities Attended (required)

EXAMPLE:Towson University EXAMPLE:Towson, MD
EXAMPLE:Towson University EXAMPLE:Towson, MD

EXAMPLE:Towson University EXAMPLE:Towson, MD
EXAMPLE:Towson University EXAMPLE:Towson, MD

EXAMPLE:Towson University EXAMPLE:Towson, MD

Veterans Information:

The following is a required field. If you are not a Veteran or a benefit eligible dependent (spouse, child) select Not Applicable on the dropdown menu.

Certification:

I certify that the statements made in this application are correct. I understand that failure to provide accurate information may result in the elimination of my application or, if admitted and enrolled, dismissal from the College. I agree to comply with all policies and regulations of Carroll Community College while I am a student. I agree to familiarize myself with and to abide by the policies and regulations of the Drug-Free Schools and Community Act, Drug-Free Workplace Act, Smoke/Tobacco-Free Campus Policy and the Code of Integrity for Academic and Behavioral Standards, which includes both personal conduct and academic integrity. (Found in the College Catalog, the Security Procedures & Policies page, and the College Code of Integrity.)

The College prohibits the enrollment of individuals listed on any State Services Sex Offender registry and/or Maryland Department of Public Safety and Correctional Services Sex Offender registry.

Please review your request before submitting. Once you hit submit please check your email for a copy of the application which will include information regarding next steps. This will be emailed to you shortly.