Application For Admission - Wayne County Community College District printable pdf download

STUDENT TYPES

Wayne County Community

Check all boxes that apply

New Student

Guest Student

Virtual Learning Collaborative

College District

Returning Student

Transfer Student

Tech Prep

When do you plan to enroll?

Summer 20 _____

Fall 20 _____

Spring 20 _____

Application for Admission

Preferred Campus

Downriver

Downtown

Eastern

Northwest

Western

Preferred Program Code ________________________________________

Associate’s

Certificate

Selected Courses

(See Insert)

Degree

Only

PRIOR ACADEMIC HISTORY

List the last or current high school attended and all colleges, universities or other post-secondary educational

programs attended.

NAME (S) OF HIGH SCHOOL (S), COLLEGE (S) OR GED CENTER

GRADUATION DATE

(Attach additional sheets if necessary)

MONTH

DATE

YEAR

Yes

Did you graduate from high school?

Name of High School

City & State

GED

Yes

Did you take Tech Prep classes in high school?

If yes, which center?

College/University

Name of College or University

City & State

STUDENT'S SIGNATURE

I certify that all information on this form is complete and accurate. I understand that falsifying any part

Downriver

Downtown

Eastern

Northwest

Western

of this application may result in cancellation of admission, registration or both. If admitted to Wayne County

21000 Northline

1001 W. Fort St.

5901 Conner

8200 W. Outer Drive

9555 Haggerty

Taylor, MI 48180-4717

Detroit, MI 48226-3001

Detroit, MI 48213-3457

Detroit, MI 48219-3580

Belleville, MI 48111-1404

Community College District, I will become knowledgeable of all College policies and regulations and will

734-946-3500

313-496-2758

313-922-3311

313-943-4000

734-699-7008

abide by them.

Student's signature

Date

NOTICE OF NON DISCRIMINATION - Any questions concerning Title IX of the Education Amendments of 1972 which prohibits discrimination on the basis of sex, or inquiries related to

Section 504 of the Rehabilitation Act of 1973 which prohibits discrimination on the basis of handicap, and inquiries related to Title II of the Americans with Disabilities Act (ADA) which

provides comprehensive civil rights protection for individuals with disabilities, or the College’s Statement of Compliance with Federal and State law, should be directed to Human

Resources, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226 or by calling: 313-496-2887.

Form 101 - 9/93, 4/94, 3/96, 7/99, 2/00, 11/03, 5/06 - 50000HDM, 7/2008