Application for General Admission

Application for General Admission

? U.S. citizens and permanent residents may apply online at mcckc.edu/apply. There is no application fee. ? International applicants (in the U.S. on a VISA, non-immigrants, undocumented or DACA) can find additional information,

including fees, at mcckc.edu/international. ? If you have taken a credit class at Metropolitan Community College (MCC) anytime during the last year (after completing high

school), you don't need to reapply, even if you skipped a semester. ? Students who took MCC classes while in high school should reapply as first time attending since high school.

PERSONAL INFORMATION

It is the policy of MCC to provide equal opportunity for all enrollment students and applicants for admission to the college, free from discrimination based on age, race, color, religion, sex, sexual orientation, national origin, and/or disability, and harassment including sexual harassment. The information you provide is kept confidential and is not used to determine acceptance for admission. Inquiries concerning compliance should be addressed to MCC's Title IX coordinators.

First Name ________________________ Middle Name __________________ Last Name _________________________

Preferred First Name ________________________

Previous Last Name _________________________

Gender

Date of Birth (mm/dd/yyyy) Social Security Number (SSN)

Male Female Prefer Not to Answer

Although providing your Social Security Number is voluntary, it is required for financial aid and/or veteran education benefits and MCC needs it in order to furnish Form 1098T, used when filing income taxes with the IRS. Providing your SSN also expedites matching to existing records during application review and processing.

Are you Hispanic or Latino? Yes No

Race American Indian/Alaska Native Asian Black/African American Native Hawaiian/Other Pacific Islander White

Citizenship/Immigration Status U.S. Citizen Naturalized Permanent Resident Refugee/Asylum DACA/Undocumented VISA Type ___________

Primary Language English Other __________________________

Country of Citizenship _____________________Country of Birth __________________City of Birth__________________

Military Status No Service Retired Veteran Active Spouse/Dependent of Active Missouri Member

Do either of your parents have a bachelor's degree?

Yes No

Are you interested in financial aid or scholarships?

Yes No

CONTACT INFORMATION

Home Address _____________________________________________________________________________________ City ____________________________________ State __________ Zip/Postal Code _______________

Only if home state is Missouri, provide the following:

County ________________________________ Public K-12 School District ________________________________

Review your property tax statement or contact your realtor, landlord or County Assessor to determine the public school district for your home address.

Rev. July 2021

Mailing Address (only if different from home) ______________________________________________________________ City ____________________________________ State __________ Zip/Postal Code _______________

Cell Phone

Home Phone

Work Phone

Preferred Phone

(_____) _________________ (_____) _________________ (_____) ___________________

Email Address _________________________________________@___________________________

Once admitted, you will be assigned a student email account that we will use for most official school correspondence.

Emergency Contact Name ______________________________ Phone (_____) _________________ Relationship ___________________

RESIDENCY STATUS

Residency status will determine the tuition rate you are charged for your classes. In accordance with Missouri law, many factors are considered when determining residency such as citizenship status, military status, the public school district to which taxes are paid, length of time at present domicile, purpose for living in Missouri, and your intent to make Missouri your permanent home. In most cases, you must have been at your in-district or in-state residence for the past 12 consecutive months to receive that residency status. For more information visit mcckc.edu/tuition.

If you are under 21 years old and not legally emancipated, answer the questions as they pertain to your parent or legal guardian. All questions in the section must be answered.

Answer the following if you provided a Missouri home address. 1. Have you (or your parent/legal guardian) lived in Missouri for the past 12 consecutive months? Yes No If yes,

a. Have you/they lived in any combination of these districts (Belton, Blue Springs, Center, Fort Osage, Grain Valley, Grandview, Hickman Mills, Kansas City, Independence, Lee's Summit, Liberty, North Kansas City, Oak Grove, Park Hill, Raytown) for the past 12 consecutive months? Yes No

2. Are you (or your parent/legal guardian) living in Missouri for the purpose of retirement, full-time employment, professional practice or to conduct a business AND intend to make Missouri your permanent home? Yes No

OR

Answer the following if you did not provide a Missouri home address. 1. Did you (or your parent/legal guardian) pay Missouri income tax last year? Yes No

2. Did you (or your parent/legal guardian) live in the state of Missouri during the last year? Yes No If yes,

a. What is the approximate date you/they moved out of Missouri? _____________________

b. Did you/they live in Missouri for at least 12 consecutive months before moving? Yes No

c. Before moving out of Missouri, did you/they live in any combination of these districts (Belton, Blue Springs, Center, Fort Osage, Grain Valley, Grandview, Hickman Mills, Kansas City, Independence, Lee's Summit, Liberty, North Kansas City, Oak Grove, Park Hill, Raytown) for 12 consecutive months? Yes No

Rev. July 2021

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EDUCATION HISTORY

Request an official transcript from each school be sent to Metropolitan Community College, Student Data Center, 3200 Broadway, Kansas City, MO 64111.

When classes start, what will best describe your high school experience? Left high school without graduating or never attended high school Completion Date _____________________ Working on/completed GED or Working on/completed HiSET Attending/graduated from a Missouri high school

School Name ___________________________________________ City____________________________________ Attending/graduated from home school Attending/graduated from a high school in a state other than Missouri Graduated from a foreign high school

Indicate all other colleges attended (including high school dual credit).

School Name

City/State or Country

Dates Attended Degree Earned Date Completed

ENROLLMENT INFORMATION

When do you plan to start classes? Fall Spring Summer 20 _____

Fall: August-December Spring: January-May Summer: June-July

Do you expect to take all your classes online? Yes No

At which campus are you most likely to seek services in-person or attend activities? Blue River Business and Technology Longview Maple Woods Penn Valley

At the time you start classes, which will best describe you? Will still be in high school/home school while earning MCC credit First time attending college since high school Completed a bachelor's degree or higher Visiting from another college (typically just for one term) Transferring (last school attended is a college other than MCC) Returning after a year or more and have not attended any other colleges

Academic Interest _________________________________ Anticipated Major _________________________________

Examples: Art, Criminology, Social Work

Examples: Computer Science, Construction Management

Primary Goal at MCC Earn a degree Earn a certificate Take classes and then transfer Take classes for job skills I do not know yet

Personal enrichment

If you select "Take classes and then transfer" or "I do not know yet" we will have you follow our Associate in Arts program. You can always discuss this with an advisor once admitted.

Rev. July 2021

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STUDENTS WITH DISABILITIES

Metropolitan Community College (MCC) is committed to ensuring equitable access for all qualified students with disabilities in accordance with the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. Each MCC campus has a Disability Support Services (DSS) office that engages in an interactive process with students to determine reasonable accommodations. Students who are requesting accommodations must self-identify and initiate the process by contacting the campus DSS Coordinator.

MCC-Blue River: 816.604.6568 MCC-Business & Technology: 816.604.5491 MCC-Longview: 816.604.2254 MCC-Maple Woods: 816.604.3192 MCC-Penn Valley: 816.604.4293

More information is available at mcckc.edu/disability.

CERTIFICATION

I hereby certify that to the best of my knowledge the information in this application is true.

? Upon admission, I agree to abide by the Student Code of Conduct and all other rules and regulations of Metropolitan Community College.

? I understand that deliberate falsification and/or omission of information pertaining to this application may result in immediate dismissal and full loss of credits.

? I understand that my tuition rate will be based on the information I have given in the residency status portion of this application.

? If I am visiting from another college, I accept responsibility for verifying whether courses will transfer and/or apply to my degree.

Applicant Signature ________________________________________ Date _____________________

U.S. Citizens and Permanent Residents: RETURN COMPLETED APPLICATION TO

Metropolitan Community College Student Data Center 3200 Broadway

Kansas City, MO 64111

Rev. July 2021

International Applicants: RETURN COMPLETED APPLICATION TO

Metropolitan Community College International Student Services 3201 Southwest Trafficway Kansas City, MO 64111

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