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School of Professional and Adult Studies

APPLICATION FOR ADMISSION

Campus:


Proposed date of entry (MM/DD/YY)

Student Type (Check only one):

Associate of Science in Business

Associate of Science in Education

Bachelor of Business Administration

Bachelor of Science in Management

Masters of Business Administration

Master of Education (K-6)

Master of Science in Management and Leadership

Special - Auditor

Special – Enrichment

Other

Please indicate other program

STUDENT STATUS (Check all that apply):

First time in any college

Attended another college

Former MC student

MC associate to bachelor

MC bachelor to master

2nd bachelor’s degree

MC employee

Permanent resident alien

International student (type of visa)

Dual enrollment with

PERSONAL INFORMATION. Please complete all items. You are not required to provide the items indicated with an asterisk. Information marked by asterisk (*) is used for compiling institutional data; it is not a factor in admissions decisions.

Last 4 Digits of Social Security Number.

- Date of Birth (MM/DD/YY)

Full Legal Name:

First	Middle	Last
Previous Name(s):	Name Called By:

Address:

Address 1

Address 2

City

State

Zip Code

County

Phone:

Home	Work	Cell
Fax	E-mail

Are you a North Carolina resident?

Yes

No

If yes, what is your county of residence?

If yes, how long have you been a North Carolina resident?

If not residing in the United States

Resident Country

Birthplace

Gender:

Male

Female

Religious Affiliation - Please enter what best describes you. (*)

Marital Status: (*)

Married

Divorced

Separated

Widowed

Single

Ethnic Background (Check only one): (*)

American Indian/Alaskan Native	Asian/Pacific Islander
Black/Non-Hispanic	Hispanic
Multiracial	White/Non-Hispanic
Non-Resident Alien

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