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Name and Contact Information

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Last Name

Email

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Street Address

City

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Birthdate *must be in mm/dd/yyyy

Program Information

Anticipated Program/ Major

Please select... Information Technology, M.S. Nursing, M.S.N.* Aviation Science and Management, B.S. Biology, B.S. Business Administration, B.S. Criminal Justice, B.S. Early Childhood Special Education, B.S. English, B.A. Health Services Administration, B.S. History, B.A. Information Technology, B.S. Information Technology (Online), B.S. Interdisciplinary Studies, B.S. Interdisciplinary Studies, B.A. Mathematics, B.S. New Media and Communications, B.A. Nursing, B.S.N. Psychology, B.S. Public Service / Human Service, B.S. Respiratory Therapy, B.S. Technical Management (Formerly Business Management), B.A.S. Art, A.A. Criminal Justice, A.S. Financial Technology (Fintech), A.S. Modern Language, A.A. Music, A.A. Nursing, A.S.N. Occupational Therapy Assistant, A.S. Political Science, A.S. Public Safety, A.S. Respiratory Therapy, A.S. Air Traffic Management, A.A.S. Aircraft Structural Technology, A.A.S. Aviation Maintenance Technology, A.A.S. Aircraft Structural Technology, Cert Aviation Maintenance Tech: Airframe, Cert Aviation Maintenance Tech: Airframe and Powerplant, Cert Aviation Maintenance Tech: Powerplant, Cert Aviation Maintenance Technology, Cert Flight Technology: Airplane, Cert Flight Technology: Helicopter, Cert Public Safety, Cert Aircraft Structural Technology - Structural Worker, Cert Airline Management, Cert Airport Management, Cert Commercial Pilot: Airplane, Cert Commercial Pilot: Helicopter, Cert Criminal Justice, Cert Cybersecurity, Cert European Union Studies, Cert Film Production, Cert Flight Instructor: Airplane, Cert Flight Instructor: Helicopter, Cert Instrument Pilot Rating: Airplane, Cert Multi-Engine Pilot: Airplane, Cert Network Administration, Cert Unmanned Aerial Systems Operator, Cert Web Design, Cert Engineering, Transfer

Anticipated Start Term

Please select... Fall Spring Summer

Anticipated Start Year

Please select... 2018 2019 2020 2021 2022

High School

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