Application for New Students

Applying for*

Spring 2020 (February 2020 start)

Summer 2020 (May 26 start & July 6 start)

Fall 2020 (August 2020 start)

Student Type*

First time at any college (as a full- or part-time student)

Transfer from another college

Former SUNY CCC student

I want to enroll *

Full-Time (12 credit hours or more)

Part-Time (Less than 12 credit hours)

Non-degree (Financial aid not available)

Apprentice (Indicate your employer below)

If you selected Apprentice above, please indicate your employer:

I am interested in applying for

Binghamton Express

Alfred State Running Start

I have earned ACE credits

Yes

No

First Name*

Last Name*

Former NameIf you have records under a different name, give former name(s)

Mailing Address*

City*

State*

Zip*

County*

Telephone*

Cell Phone*

Email

Gender

Date of Birth (mm/dd/yyyy)*

Are you a US citizen*

Yes

No

Are you Hispanic/Latino?

Yes

No

If Hispanic/Latino, is your background (check one):

Central American

Dominican

Mexican

Other Hispanic/Latino

Puerto Rican

South American

Other applicants (select one or more):

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific

White

Are you a veteran of the US Armed Forces?

Yes

No

Are you eligible for the GI Bill/VA Education Benefits?

Yes

No

Are you a spouse/dependent (child) of a veteran and eligible for VA Education benefits?

Yes

No

Have you ever been dismissed from a college for disciplinary reasons (not academic)?

Yes

No

What are your career and educational goals

Has anyone in your immediate family earned a college degree?

Yes

No

High School Information *

Graduated or will graduate from high school. Put date below.

Did not graduate from high school, but earned a state high school equivalency diploma [GED/TASC]. Put date below.

Did not graduate from high school nor earn a state high school equivalency diploma. Please call to discuss options.

Homeschooled. Put graduation date below.

Graduation/GED date (mm/dd/yyyy)*

Transcript Instructions

Ask your high school to send/fax your official transcript directly to SUNY CCC, or, if applicable, send us a copy of your high school equivalency (i.e. GED diploma and scores), or a copy of your External High School diploma. Mailing Address: Admissions Office, One Academic Drive, Corning, NY 14830. Fax: 607-962-9582.

Transfer Students

Ask your previous college to mail your official college transcripts directly to the SUNY CCC Office of Admissions. We will notify you of your status soon after your application and records are received. Upon your acceptance, you will receive directions for scheduling assessment tests, advising, and course registration.

High School currently attending or last attended*

High School mailing address (include street, city, state, zip)

Name & Address of Previously Attended College(s)

You can contact my high school counselor for admissions-related information

Yes

No

Release and Signature: The information provided in this application is correct to the best of my knowledge. The high school named in this application has my permission to release requested records to SUNY Corning Community College. I understand that by submitting this application, I will be contacted by SUNY Corning Community College for the purposes of beginning the enrollment process, which may include missing documentation, scheduling assessment testing, reminder calls for appointments, scheduling registration appointments, follow up communication to assist the student with enrolling in classes and preparedness for the first day of classes. SUNY Corning Community College will communicate to students through traditional communication, as well as email, automated calling, and text messaging. You will need to let the Office of Admissions know if there is a method in which you do not want to be communicated with.

Signature*

Date*

The Personal Privacy Protection law requires this notice to be provided when collecting personal information from individuals. The information on this application will be used to evaluate your request for admission. The application information will be maintained in the Admissions and the Registration and Records offices. The official responsible for maintenance of this information is the Vice President and Den of Enrollment Management and Student Development. SUNY Corning Community College is an equal employment and educational opportunity institution, and does not discriminate on the basis of race, color, creed or religion, gender, sexual orientation, national origins, age or physical or mental disability, or other factors which cannot be legally used as the basis for employment or educational decisions.