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To be admitted to a curriculum, you must be a high school graduate or have a high school equivalency (GED) certificate. If you do not want to wotoward a degree, diploma or certificate, you can enroll as a special credit student.

You must have official transcripts from your high school or GED and each post-secondary institution mailed directly to the Admissions Office.All students, including special credit/non-degree seeking students MUST provide evidence of having met all course prerequisites before beingallowed to register for classes.

Students should complete their admissions file prior to enrollment. Failure to do so may impact registration.

Instructions: Please type or print in ink. Please write legibly. Respond to all questions completely, use your legal name and return the applicationto the Admissions Office at the address shown above. Incomplete applications will be returned.

Have you previously applied to GTCC? Yes No Currently enrolled, applying to a limited enrollment program? Yes

1. ___________ /_________ / ___________*Social Security Number

2. ______________________________________________________________________________________________________________________Last Name First Middle Former

3. ______________________________________________________________________________________________________________________Address City State Zip

4. ______________________________________________________________________________________________________________________County of legal residence State of legal residence Country of legal residence

5. ( ) __________________ ( ) _______________________ ext. ________area code Home Telephone area code Business Telephone

6. Date of birth: ___________/_______ /___________ (mmddyy) 7. * Ethnicity: Hispanic or Latino Yes No

8. * Race: Choose one or more: White Black or African American Native Hawaiian or Other Pacific Islander

Asian American Indian or Alaskan Native9. * Gender: F M 10. E-Mail Address: ___________________________________________________

11. Year/Term entering 20________ Fall Spring Summer

12. Curriculum for which you are applying or Program of interest: ________________________________________________________(Please indicate one program only)

13. Nursing Applicants check one option only: Day RN Program (Fall start) Evening & Weekend RN Program (Spring start) Day LPN (Fall start)If you are currently an LPN are you interested in: Day Bridging or Evening Bridging

14. Enrolling as a: Freshman (No previous college course work) Transfer (Any previous college course work) Returning GTCC student

15. Long term goal at GTCC (check one only): GR To obtain an Associate Degree Diploma or Certificate

TR To take courses to transfer to another college without earning a degree at GTCC

EP To enhance job skills in present field of work

EN To enhance employment skill for a new field of work

PE To take courses for personal enrichment or interest

GU Undecided

APPLICATION FOR ADMISSIONGuilford Technical Community College

P.O. Box 309 Jamestown, NC 27282If you have questions about this application, call 336-334-4822/336-454-1126

Please read before completing application

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* This information is required if you intend to file for Financial Aid and to provide verification of the

Hope tax credit.

Federal regulations require that institutions provide consumer information about the school.

The Consumer Disclosure is located at: http://www.gtcc.edu/departments/nancialAid/generalInfo/consumerInfo.html

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27. High school attended: ____________________________City____________________County_________________State__________

28. High school graduation: What year did you graduate? ____________________ ; or What year will you graduate? ___________________

29. Is/was your high school: _____ public, _____ private, _____ homeschool or _____ correspondence school?

30. If GED/AHS graduate where was it earned?_________________________ _____________ Month and Year Earned: ________/____

31. If GED/AHS graduate, last school attended prior to earning GED/AHS:__________________ _________Last Year Attended:_________

32. List all colleges attended: (Please list full college name)College __________________________________________ City/State_______________________ Dates_______ /_______College __________________________________________ City/State_______________________ Dates_______/________College __________________________________________ City/State ______________________ Dates_______/________

I certify that the information on this application is correct and complete. I understand that providing false or incompleteanswers may disqualify me from admission and enrollment at Guilford Technical Community College.

I agree to abide by the rules and regulations of the college when I am admitted as a student.

_____________________________________________ ______/______/______

Signature Date

16. I am currently: GTCC Employee Military/ Military Dependent Senior Citizen *65+ Consortium

If you are a veteran, please check one of the three following categories: Special Disabled Veteran Vietnam Era Veteran Other Eligible Veteran

17. United States Citizen: Yes No (If no, proof of residency status must accompany application.)

If no, status: Resident Alien Refugee Asylee Visa Visa type_________ Other_________________________

Country of Origin_______________________________________________

18. North Carolina legal resident: Yes No

19. Have you resided in North Carolina continuously for the past 12 months? Yes NoIf no, indicate where you resided and for what reason: ________________________________________________________________

20. Are you dependent on your parents? Yes No (If yes, list name and address, city, & state):___________________________________________________________________________________________________________________________________

*ThisisvoluntaryinformationusedforFederalreportingandhasnobearingonadmissiontothecollege.

GTCCisanAfrmativeAction/EqualOpportunityCollege.

(state)

(state)

02/

From (Yr.) / To (Yr.)

21. * Employment Status:E1 1-10 hrs./weekE2 11-20 hrs./weekE3 21-39 hrs./weekE4 40+ hrs./weekR RetiredUN Unemployed- not seeking employment

US Unemployed-seeking employment23. High School Status: Currently enrolled in high school

High school graduate Certificate of completion GED graduate Adult high school graduate

(through a community college) Did not graduate

25. Highest grade father completed (check one): Less Than 10th 13 -- Adult HS (through a community college) 10th 14 -- College Vocational Diploma 11th 15 -- Associates

12th 16 -- Bachelors GED 17 -- Masters or higher

22. Highest grade student completed (check one): Less Than 10th 13 - Adult HS (through a community colle 10th 14 - College Vocational Diploma 11th 15 - Associates 12th 16 - Bachelors GED 17 - Masters or higher

26. Highest grade mother completed (check one): Less Than 10th 13 - Adult HS (through a community colle 10th 14 - College Vocational Diploma 11th 15 - Associates

12th 16 - Bachelors GED 17 - Masters or higher

24. High School Track(s): CTP - College Tech Prep/Tech PrepGP - General PrepOT - Other TrackUN - Unknown TrackCP - College PrepVP - Vocational Prep