Chesapeake College Admissions Application - Free Download | Page 2
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Chesapeake College Admissions Application
MILITARY STATUS
Are you a veteran or a dependant (including spouse) of a veteran Yes If yes, check one: Veteran Dependant
If you are active duty military, where are you stationed ________________________________________________________________________ (To be considered for in-
county or in-state tuition due to BRAC, you will need to provide your orders to the Registration office at the Wye Mills Campus for verification.)
CITIZENSHIP INFORMATION
CITIZENSHIP (Please check one option)
U.S. Citizen (US)
Permanent Resident (RA) (The applicant must present the Permanent Resident Card to the Admissions Office staff at the Wye Mills Campus for
verification prior to college acceptance.) A copy of the Card will be made and included with this admissions application. In the absence of documentation, a
student is charged out-of-state tuition and fees.
Non-U.S. Citizen (NA) (If you checked Non-U.S. Citizen, you must state your country of citizenship here: ___________________________________________)
Are you here on a VISA Yes No If yes, state type of VISA: ________________________________________________
VISA #: ______________________________________________________________________________________________
To all VISA Holders: You must submit your original documentation to the Admissions Office at the Wye Mills campus for verification prior to college
acceptance.
Country of Citizenship: _______________________________________________________
Do you plan to enroll at Chesapeake College as a visiting student and maintain an F1 status at your home school Yes No
All VISA students must contact the Registrar at Chesapeake College for admission and enrollment information and procedures.
Application deadlines for International Students: June 1 for the Fall semester November 1 for the Spring semester
PERSONS TO CONTACT IN CASE OF EMERGENCY
Last Name: First Name: Middle Initial:
Relationship to you: Parent/Guardian Spouse Other
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Last Name: First Name: Middle Initial:
Relationship to you: Parent/Guardian Spouse Other
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
FIRST-GENERATION STUDENT INFORMATION
Your parent’s educational level: Mother Father
Less than high school
Completed high school or GED
Some college, but no degree
Two-year college degree
Four-year college degree
Advanced degree (Graduate or Professional)
Unknown
SEMESTER START STATUS
Semester/Year applied for: Fall (Aug.-Dec.) Spring (Jan.-May) Summer (June-Aug.) Year 20__ __
Are you applying for Financial Aid Yes No
Admission Status: (check one)
(FF) First-time Freshman (never attended a college/university after
high school)
(HS) High School (attending while still enrolled in high school)
(ND) Non-Degree seeking (taking courses WITHOUT intention
of earning a Chesapeake College degree)
(R3) Returning Student (returning to Chesapeake after absence of
three semesters or longer)
(RT) Returning Student (returning to Chesapeake after absence of
less than three semesters)
(TR) Transfer (transferring from another college to Chesapeake)
(VS) Visiting Student (enrolled at another college and planning to
transfer Chesapeake College coursework back to home institution)
Academic Goal
Please check the one statement which most closely corresponds to your primary reason for
attending Chesapeake College:
1). Exploration of new career or academic area
2). Preparation for immediate entry into a career
3). Preparation for transfer to a four-year institution
4). Preparation for a job I currently hold
5). For interest and self-enrichment
6). Visiting student
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