Name
General Information
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Legal Sex
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Social Security Number
If you do not have a social security number enter all zeros.
Marital Status
Divorced Married Other Single Widowed
Did you claim another individual as a dependent on your most recent taxes?
Yes
No
Ethnicity/Race
Colleges and universities are asked by many groups, including the federal government, accrediting associations, college guides, newspapers, and our own college/university communities, to describe the racial/ethnic backgrounds of our students and employees. In order to respond to these requests, we ask you to answer the following question(s)
Select the option that best describes your ethnicity
Hispanic/Latino Not Hispanic/Latino
Contact Information
Mailing Address
Address Line 1
Address Line 2
City
State
Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas British Columbia California Canada Canal Zone Colorado Connecticut Delaware District of Columbia Fed States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territories Northern Mariana Islands Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas U.S. Minor Outlying Isl. Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
Zip
Country
(retired) COTE D'IVOIRE (retired) CZECHOSLAVAKIA (retired) GERMAN DEMOCRATIC REPUB. (retired) IRAQ-SAUDI ARABIA (retired) NETHERLANDS ANTILLES (retired) PARACEL ISLANDS (retired) UNION OF SOVIET SOCIALIS (retired) US PERMANENT RESIDENT (retired) VISA STATUS (retired) YEMEN,PEOPLES DEMOC REP (retired) YUGOSLAVIA (retired) ZAIRE AFGHANISTAN LAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA (PLURINATIONAL STATE OF) BONAIRE, SINT EUSTATIUS AND SABA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CABO VERDE CAMBODIA CAMEROON CANADA CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLAND COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CTE D'IVOIRE CROATIA CUBA CURAAO CYPRUS CZECHIA DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ESWATINI ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MAYOTTE MEXICO MICRONESIA (FEDERATED STATES OF) MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH MACEDONIA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINE, STATE OF PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN (FRENCH PART) SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN (DUTCH PART) SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SOUTH SUDAN SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND UNITED STATES MINOR OUTLYING ISLANDS UNITED STATES OF AMERICA UNKNOWN OR UNSPECIFIED URUGUAY UZBEKISTAN VANUATU VENEZUELA (BOLIVARIAN REPUBLIC OF) VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
I live outside the United States
Do you live at your mailing address
Yes
No
Permanent Address
Address Line 1
Address Line 2
City
State
Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas British Columbia California Canada Canal Zone Colorado Connecticut Delaware District of Columbia Fed States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territories Northern Mariana Islands Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas U.S. Minor Outlying Isl. Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
Zip
Country
(retired) COTE D'IVOIRE (retired) CZECHOSLAVAKIA (retired) GERMAN DEMOCRATIC REPUB. (retired) IRAQ-SAUDI ARABIA (retired) NETHERLANDS ANTILLES (retired) PARACEL ISLANDS (retired) UNION OF SOVIET SOCIALIS (retired) US PERMANENT RESIDENT (retired) VISA STATUS (retired) YEMEN,PEOPLES DEMOC REP (retired) YUGOSLAVIA (retired) ZAIRE AFGHANISTAN LAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA (PLURINATIONAL STATE OF) BONAIRE, SINT EUSTATIUS AND SABA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CABO VERDE CAMBODIA CAMEROON CANADA CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLAND COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CTE D'IVOIRE CROATIA CUBA CURAAO CYPRUS CZECHIA DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ESWATINI ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MAYOTTE MEXICO MICRONESIA (FEDERATED STATES OF) MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH MACEDONIA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINE, STATE OF PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN (FRENCH PART) SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN (DUTCH PART) SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SOUTH SUDAN SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND UNITED STATES MINOR OUTLYING ISLANDS UNITED STATES OF AMERICA UNKNOWN OR UNSPECIFIED URUGUAY UZBEKISTAN VANUATU VENEZUELA (BOLIVARIAN REPUBLIC OF) VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Enrollment Information
Have you ever enrolled at MCC?
This is my first time enrolling in any college for credit
I will be new to MCC with prior college credit
I will be a returning MCC student
Academic term & year you plan to enroll
Summer 2021-2022 (05/23/22 - 07/19/22) Fall 2022-2023 (08/22/22 - 12/09/22)
When do you plan on attending classes?
Morning
Afternoon
Evening
Weekends
Online
Degree Declaration
Accounting (Degree) Administration of Justice (Degree) Advanced Automotive Technician (Certificate) AGEC - A (Certificate) AGEC - B (Certificate) AGEC - S (Certificate) Art (Degree) Art, Visual Communication (Degree) Auto Bodywork (Certificate) Automotive Estimating (Certificate) Automotive Refinishing (Certificate) Baking & Pastry (Certificate) only at BHC Basic Automotive Technician (Certificate) Business - Bookkeeping (Certificate) Business - Retail Management (Certificate) Business Administration (Degree) Business and Entrepreneurship (Certificate) Business and Entrepreneurship (Degree) Caregiver Program (Non Degree) Chemistry (Degree) Computer Graphics & Web Design (Certificate) Computer Graphics & Web Design (Degree) Computer Info Systems Administration (Degree) Computer Information Systems (Degree) Computer Science (Degree) Corrections Officer (Certificate) Culinary & Hospitality Mgmt (Cert) only at BHC Culinary & Hospitality Mgmt (Degree) only at BHC Cybersecurity and Network Support (Certificate) Cybersecurity and Network Support (Degree) Dental Assisting (Certificate) only at BHC Dental Hygiene (Degree) only at BHC Early Childhood Education (Degree) Education (Degree) Electrical - Residential Wiring (Certificate) Electrical Technology - Commercial/Industrial Elec Engineering (Degree) English (Degree) Fire Fighter (Certificate) Fire Science (Degree) Food Management (Certificate) Food Preperation (Certificate) General Studies (Degree) Geology (Degree) Healthcare Information Technology (Degree) History (Degree) HVAC Installation (Certificate HVAC Residential (Certificate) HVAC/R Light Commercial (Certificate) Liberal Arts (Degree) Life Science (Degree) LPN to RN Track (Degree) Mathematics (Degree) Medical Assistant (Certificate) Medical Assistant: Phlebotomy (Certificate) Medical Assisting: Billing/Insurance Coding (Cert) Non-Degree Seeking Nursing - Nurse Refresher Program (Non-Degree) Nursing Assistant Program (Non-Degree) Nursing RN (Degree) Paralegal (Certificate) Paralegal (Degree) Paramedic (Certificate) Paramedic (Degree) Physical Therapist Asst.(Degree) only at LHC Practical Nursing (Certificate) Professional Applications (Certificate) Programming & Game Development (Certificate) Radiologic Technology (Degree) only at BHC Science (Degree) Social & Behavioral Science (Degree) Social Studies (Degree) Substance Abuse Counseling (Degree) Substance Abuse Counseling Post-Degree Certificate Surgical Technology (Degree) only at LHC Surgical Technology, CST Pathway (Degree) Welding Tech - Fillet Weld (Certificate) Welding Tech - GMAW/FCAW Pipe (Certificate) Welding Tech - GMAW/FCAW Plate (Certificate) Welding Tech - GTAW Pipe (Certificate) Welding Tech - GTAW Plate (Certificate) Welding Tech - SMAW Pipe (Certificate) Welding Tech - SMAW Plate (Certificate)
If you are seeking to pursue multiple programs simultaneously or wish to change your program of study from what is selected here, you will need to meet with an academic advisor to complete a degree declaration form to add these programs to your student account.
If you are planning on applying for Financial Aid or Veteran Educational Benefits, the degree declaration is an important component of eligibility.
Have you previously attended any other college or university?
No
Yes
Do you have a GED?
No
Yes
Reason for Enrolling
Earn an MCC Degree/Certificate
Prepare to enter job market
Transfer to College/University
Personal Interest
Enhance present career
Prepare to change careers
GED
Why did you choose MCC?
Affordable Tuition
Availability of Financial Aid and Scholarship Opportunities
Specific Field of Study
Quality of Education
Flexible Course Scheduleing and Delivery
Location
Campus Experience
Extracurricular Activities
What will your employment status be while enrolled?
Not employed
Employed full time
Employed part time
Have either of your parents completed a four-year college degree?
Yes
No
Are you a Veteran or active duty Service Member of the US Armed Forces?
Yes
No
Will you be using VA educational benefits while pursuing your degree here at MCC?
Yes
No
Citizenship
Student must be prepared to provide evidence of citizenship, permanent residency or other lawful immigration status.
Are you a U.S. Citizen?
Yes
No
I am a Citizen of
(retired) COTE D'IVOIRE (retired) CZECHOSLAVAKIA (retired) GERMAN DEMOCRATIC REPUB. (retired) IRAQ-SAUDI ARABIA (retired) NETHERLANDS ANTILLES (retired) PARACEL ISLANDS (retired) UNION OF SOVIET SOCIALIS (retired) US PERMANENT RESIDENT (retired) VISA STATUS (retired) YEMEN,PEOPLES DEMOC REP (retired) YUGOSLAVIA (retired) ZAIRE AFGHANISTAN LAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA (PLURINATIONAL STATE OF) BONAIRE, SINT EUSTATIUS AND SABA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CABO VERDE CAMBODIA CAMEROON CANADA CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLAND COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CTE D'IVOIRE CROATIA CUBA CURAAO CYPRUS CZECHIA DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ESWATINI ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MAYOTTE MEXICO MICRONESIA (FEDERATED STATES OF) MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH MACEDONIA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINE, STATE OF PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN (FRENCH PART) SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN (DUTCH PART) SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SOUTH SUDAN SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND UNITED STATES MINOR OUTLYING ISLANDS UNITED STATES OF AMERICA UNKNOWN OR UNSPECIFIED URUGUAY UZBEKISTAN VANUATU VENEZUELA (BOLIVARIAN REPUBLIC OF) VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Do you have a Permanent Resident/Green card?
Yes
No
Do you hold a valid Non-Immigrant Visa?
Yes
No
Which type of Via do you have?
B-1/B-2 Visa F-1 Foreign students at an approved academic institution F-2 Spouse or qualifying child of an F-1 nonimmigrant H-1 Visa H-4 Visa J-1 Foreign nationals in exchange visitor program in the US J-2 Spouse or qualifying child of an J-1 nonimmigrant M-1 Foreign nationals at OISS-approved vocational school M-2 Spouse or qualifying child of an M-1 nonimmigrant
Residency Status
To be considered an Arizona resident for tuition purposes, you must have resided in the state continuously for at least 12 months prior to submitting this admission application.
Do you reside in the state of Arizona?
Yes
No
I do not reside in the United States
What country do you reside in?
(retired) COTE D'IVOIRE (retired) CZECHOSLAVAKIA (retired) GERMAN DEMOCRATIC REPUB. (retired) IRAQ-SAUDI ARABIA (retired) NETHERLANDS ANTILLES (retired) PARACEL ISLANDS (retired) UNION OF SOVIET SOCIALIS (retired) US PERMANENT RESIDENT (retired) VISA STATUS (retired) YEMEN,PEOPLES DEMOC REP (retired) YUGOSLAVIA (retired) ZAIRE AFGHANISTAN LAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA (PLURINATIONAL STATE OF) BONAIRE, SINT EUSTATIUS AND SABA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CABO VERDE CAMBODIA CAMEROON CANADA CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLAND COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CTE D'IVOIRE CROATIA CUBA CURAAO CYPRUS CZECHIA DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ESWATINI ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUERNSEY GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISLE OF MAN ISRAEL ITALY JAMAICA JAPAN JERSEY JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MAYOTTE MEXICO MICRONESIA (FEDERATED STATES OF) MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTH MACEDONIA NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINE, STATE OF PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT BARTHLEMY SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA SAINT KITTS AND NEVIS SAINT LUCIA SAINT MARTIN (FRENCH PART) SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SINT MAARTEN (DUTCH PART) SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SOUTH SUDAN SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND UNITED STATES MINOR OUTLYING ISLANDS UNITED STATES OF AMERICA UNKNOWN OR UNSPECIFIED URUGUAY UZBEKISTAN VANUATU VENEZUELA (BOLIVARIAN REPUBLIC OF) VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Have you resided in Arizona continuously for the last 12 months?
Yes
No
What is/was your state of residence?
Alabama Alaska Alberta American Samoa Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas British Columbia California Canada Canal Zone Colorado Connecticut Delaware District of Columbia Fed States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territories Northern Mariana Islands Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas U.S. Minor Outlying Isl. Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
While I have not been a resident of Arizona for 12 continuous months,
I live in Arizona with my parent(s) and they claim me as a dependent on their tax return.
I am employed as a full-time teacher or full-time non-certified classroom aide by an AZ school di
I or my spouse was required by an employer to transfer to Arizona.
I am a member and resident of a tribe whose reservation lies partially or wholly in Arizona.
I am, my spouse is, or I am a dependent of a current member of the Armed Forces of the US.
I am, or I am a dependent of an honorably discharged member of the Armed Forces of the US.
GED Information
GED Test Date
MM/DD/YYYY format
GED Testing Center State
Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Europe Armed Forces Pacific Armed Forces the Americas British Columbia California Canada Canal Zone Colorado Connecticut Delaware District of Columbia Fed States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territories Northern Mariana Islands Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas U.S. Minor Outlying Isl. Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon
High School Information
Did you graduate or are currently a student in high school?
Yes
No
Student Support Documentation
In order to determine your appropriate tuition rate, MCC asks for you to upload a government-issued photo ID and Social Security Card. All students are initially defaulted to our Out-of-State tuition rate until documentation has been submitted and reviewed.
If you are unable to provide the necessary documents now, you will receive an email from Enrollment Services directing you to scan required documents into the MCC secure site. Required documents may include any of the following: Social Security card, Driver's License, Permanent Resident Card, Visa, Foreign Passport. All applicants are considered out-of-state students until Residency and Citizenship documents have been reviewed by Enrollment Services. Once documents have been reviewed, your tuition status will be determined.
For questions regarding acceptable documents, please email enrollmentservices@mohave.edu.
Acknowledgment
By submitting this form, I hereby certify that, to the best of my knowledge, the information furnished is true and complete without intention of evasion or misrepresentation. I understand the above information submitted is under penalty of perjury, and false or misrepresentative data is sufficient cause for rejection of this admission form.
By submitting this application, I agree to abide by the student rules and regulations of the institution regarding conduct and other obligations during my time with Mohave Community College.
I have read and understand the paragraph above (required)
What's Next?
Once your application has been processed your MCC ID number will be emailed to you along with a link to register for Student Orientation and the next steps needing to be taken in order to register for classes.
Submit Application
Title IX is a federal law that makes it illegal to discriminate against a person on the basis of sex in any federally funded activity.
Title IX Coordinator
Danette Bristle
dbristle@mohave.edu
TitleIX@mohave.edu
Wk: 928.704.9480
Cell: 928.542.6920