Educational Experience Summary (Application For Admission)
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1
2EDUCATIONAL EXPERIENCE SUMMARY
Deadline Dates For Submitting
Mr.
Ms. Name: (Given) __________________(Middle) ______________________(Family) __________________________________________
Applications for Admission
To be completed by the applicant. Enter only one school year on each line beginning with your first time in school through high school.
June 1 — Fall
September 1 — Spring
February 1 — Summer
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2
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Year in
Calendar
Calendar
Kind of School
Certificates/
School
Your Age
Year
Year
Elementary, Etc.
Graduation
1.
2.
Wayne County Community College District
3.
4.
5.
6.
7.
8.
9.
APPLICATION
10.
FOR
11.
ADMISSION
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17.
LOCATIONS:
DOWNRIVER CAMPUS
DOWNTOWN CAMPUS
21000 Northline
1001 W. Fort
18.
DISTRICT OFFICE
Taylor, MI 48180-4717
Detroit, MI 48226-3001
801 W. Fort
Telephone:
Telephone:
Detroit, MI 48226-3095
734-946-3500
313-496-2758
I understand that I must register full-time, must not work, must report my correct address to the
Please carefully check to ensure
313-496-2600
Voice/TDD 734-374-3206
Voice/TDD 313-496-2708
school and authorize WCCCD to notify Immigration if I fail to comply with these and other
that all questions have been
rules set forth by the Immigration and Naturalization Services.
answered before submitting this
I affirm that the information provided on this application is true and accurate to the best of my
form.
EASTERN CAMPUS
NORTHWEST CAMPUS
WESTERN CAMPUS
knowledge.
5901 Conner
8200 W. Outer Drive
9555 Haggerty
Detroit, MI 48213-3457
Detroit, MI 48219-3580
Belleville, MI 48111-1404
Student’s Signature __________________________________Date ____________________
Telephone:
Telephone:
Telephone:
313-922-3311
313-943-4000
734-699-7008
Voice/TDD 313-579-6923
Voice/TDD 313-943-4073
Should any of the information contained in this form change, you are required to file a Change of Data
form (available from the Admissions Office) as soon as possible to ensure that your records are accurate
and up-to-date. The College assumes no liability to obtain this information from any other source.
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