Please fill out as completely as possible. Incomplete applications may not be considered.

All fields marked with an * are required

 

Contact Information

First Name *
Last Name *
Middle Name/Initial
Address *
City *
State *
Zip *
Primary Phone *
Secondary Phone
Email *
Contact Preference:         

Education

Graduated: (Highest Level)*            
Graduation Date
Degree(s) Earned
If High School was not completed, anticipated Graduation Date:
Have you earned a GED
Please note: Verification of completion of high school or GED and/or transcript, if transfer student, will be required at time of enrollment.
List any college(s) or aviation training programs previously attended. State "NONE" if you are an independent student.
Previous Training


Enrollment Interest and Needs

Anticipated Enrollment Semester*            
Entering the program as: *         
Which Academic Program are you interested in? *            
Will you require assistance in finding student housing? * Ÿ      


Demographic Information

Educational institutions that are recipients of federal dollars are required by the Federal government to solicit certain demographic information to meet federal reporting requirements. Applicants are requested to provide the following information voluntarily. This information will not be utilized in a discriminatory manner.

Nation of Citizenship
Race / National Origin
Native Language
Gender
Are you a veteran of the U.S. Military? *      
If so, Which Branch?
Birth Month (MM)
Birth Day (DD)
Birth Year (YYYY)


Information Request Agreement

I certify that I have read and understand the information on this request and that the answers given by me to the foregoing questions are complete and true to the best of my knowledge and belief. *

I Agree *