STUDENT TYPES Check all boxes that apply ❒ New Student ❒ Guest Student ❒ Virtual Learning Collaborative ❒ Returning Student ❒ Transfer Student ❒ Tech Prep When do you plan to enroll? ❒ Summer 20 _____ ❒ Fall 20 _____ ❒ Spring 20 _____ Preferred Campus ❒ Downriver ❒ Downtown ❒ Eastern ❒ Northwest ❒ Western Preferred Program Code ________________________________________ ❒ Associate’s ❒ Certificate ❒ Selected Courses (See Insert) Degree Only PRIOR ACADEMIC HISTORY List the last or current high school attended and all colleges, universities or other post-secondary educational programs attended. NAME (S) OF HIGH SCHOOL (S), COLLEGE (S) OR GED CENTER GRADUATION DATE (Attach additional sheets if necessary) MONTH DATE YEAR Did you graduate from high school? ❒ Yes ❒ No Name of High School City & State GED ❒ Yes ❒ No Did you take Tech Prep classes in high school? ❒ Yes ❒ No If yes, which center? College/University Name of College or University City & State STUDENT'S SIGNATURE I certify that all information on this form is complete and accurate. I understand that falsifying any part of this application may result in cancellation of admission, registration or both. If admitted to Wayne County Community College District, I will become knowledgeable of all College policies and regulations and will abide by them. Student's signature Date Form 101 - 9/93, 4/94, 3/96, 7/99, 2/00, 11/03, 5/06 - 50000HDM, 7/2008 Wayne County Community College District www.wcccd.edu Application for Admission Downriver 21000 Northline Taylor, MI 48180-4717 734-946-3500 Downtown 1001 W. Fort St. Detroit, MI 48226-3001 313-496-2758 Eastern 5901 Conner Detroit, MI 48213-3457 313-922-3311 Northwest 8200 W. Outer Drive Detroit, MI 48219-3580 313-943-4000 Western 9555 Haggerty Belleville, MI 48111-1404 734-699-7008 NOTICE OF NON DISCRIMINATION - Any questions concerningTitle IX of the Education Amendments of 1972 which prohibits discrimination on the basis of sex, or inquiries related to Section 504 of the Rehabilitation Act of 1973 which prohibits discrimination on the basis of handicap, and inquiries related toTitle II of the Americans with Disabilities Act (ADA) which provides comprehensive civil rights protection for individuals with disabilities, or the College’s Statement of Compliance with Federal and State law, should be directed to Human Resources, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226 or by calling: 313-496-2887.
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Application forAdmission - Wayne County Community … District Application forAdmission Downriver 21000 Northline Taylor, MI 48180-4717 734-946-3500 Downtown 1001 W. Fort St. Detroit,
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STUDENT TYPES
Check all boxes that apply
� New Student �Guest Student �Virtual Learning Collaborative
�Returning Student �Transfer Student �Tech Prep
When do you plan to enroll? � Summer 20 _____ � Fall 20 _____ � Spring 20 _____
Preferred Program Code ________________________________________ � Associate’s �Certificate � Selected Courses(See Insert) Degree Only
PRIOR ACADEMIC HISTORYList the last or current high school attended and all colleges, universities or other post-secondary educationalprograms attended.
NAME (S) OF HIGH SCHOOL (S), COLLEGE (S) OR GED CENTER GRADUATION DATE(Attach additional sheets if necessary) MONTH DATE YEAR
Did you graduate from high school? � Yes � No
Name of High School
City & State
GED � Yes � No
Did you take Tech Prep classes in high school? � Yes � No
If yes, which center?
College/University
Name of College or University
City & State
STUDENT'S SIGNATUREI certify that all information on this form is complete and accurate. I understand that falsifying any partof this application may result in cancellation of admission, registration or both. If admitted to Wayne CountyCommunity College District, I will become knowledgeable of all College policies and regulations and willabide by them.
Downriver21000 NorthlineTaylor, MI 48180-4717734-946-3500
Downtown1001 W. Fort St.Detroit, MI 48226-3001313-496-2758
Eastern5901 ConnerDetroit, MI 48213-3457313-922-3311
Northwest8200 W. Outer DriveDetroit, MI 48219-3580313-943-4000
Western9555 HaggertyBelleville, MI 48111-1404734-699-7008
NOTICE OF NON DISCRIMINATION - Any questions concerning Title IX of the Education Amendments of 1972 which prohibits discrimination on the basis of sex, or inquiries related toSection 504 of the Rehabilitation Act of 1973 which prohibits discrimination on the basis of handicap, and inquiries related to Title II of the Americans with Disabilities Act (ADA) whichprovides comprehensive civil rights protection for individuals with disabilities, or the College’s Statement of Compliance with Federal and State law, should be directed to HumanResources, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226 or by calling: 313-496-2887.
LAST FIRST MIDDLE
CURRENT ADDRESS AND PHONE NUMBERS
NUMBER & STREET P.O. B0X OR APARTMENT
CITY STATE ZIP CODE
•
HOME TELEPHONE NUMBER
• •
M M D D Y Y
• • • •
SOCIAL SECURITY NUMBER DATE OF BIRTH GENDER
� FEMALE � MALE
Are you a veteran? � Yes � No
V.A. certificate#
PLEASE INDICATE YOUR RACIAL ORETHNIC HERITAGE:
Are you a resident in theWCCCD District? �Yes � No
County of residence
How long have you lived there?
RESIDENCYStudents residing in the College District will be charged residenttuition rates.The College District is defined as the whole of WayneCounty with the exception of the following cities and townships:Dearborn, part of Dearborn Heights, Garden City, Highland Park,Livonia, Northville, Plymouth and part of CantonTownship.Residency will be verified by voter registration card, driver's license,tax or rent receipts, or state identification card.
Are you a U.S. Citizen? �Yes � No
Country of Citizenship
Country of birth
Type of Visa
Date of Visa
Visa #
If you are a Naturalized U.S. Citizen, submit a photocopy ofyour Alien Registration Card with this application.
� African American(Non Hispanic)
� American Indian/Alaskan Native
�Caucasian (Non Hispanic)
� Asian/Pacific Islander
� African
� Hispanic: Puerto RicanMexican-American, Cubanand other Latino Cultures
� Arabic/Middle Eastern
� Other
� No response
Is English your second language? � Yes � No
If yes, what is your primary language?
This section is optional and will not be considered indetermining admissibility. Federal regulations do requireWCCCD to report this.
Wayne County Community College District
APPLICATION FOR ADMISSION
E-MAIL ADDRESS
WELCOME STATEMENT
WELCOME toWayne County Community College District. Our mission is to empower individuals, businesses
and communities to achieve their goals through excellent and accessible services, culturally diverse
experiences, and globally competitive higher education and career advancement programs.
Wayne County Community College District offers an affordable, quality education for today and tomorrow.
ADMISSIONS PROCEDURESNEW STUDENTSAdmission to Wayne County Community College District is “Open Door”; it is automatic for those who are 18 or
older. Admission to specific programs is not automatic. New students are required to complete this Application for
Admission and submit it to the District Office of Admissions at 801 W. Fort St., Detroit, MI 48226. For those under
18 years of age, the possession of a high school diploma or approval of a parent or guardian is required to
accompany the Application for Admission.
Current high school Juniors and Seniors may apply for enrollment in WCCCD classes by completing the Dual or
Concurrent Enrollment form along with submitting written permission from a parent or guardian and the high
school principal. This form should be submitted to the Office of Admissions. Persons under age 18 must resubmit
the Dual or Concurrent enrollment form and be approved for each semester for which they intend to enroll
regardless of previous enrollments.
Step 1: Apply for Admission• Complete and submit the Application for Admission. Returning students (students who have
not attended WCCCD in two or more years) should complete the admissions application andsubmit transcripts of previously attended colleges/universities.
• Take the placement test (COMPASS) in the testing room at the campus of your choice.
Step 2: Meet with an Academic Advisor• Discuss assessment results.
• Discuss and explore your course options, educational goals and develop an educational plan.
• Activate your PIN so you can register online through Web-Gate
Step 3: Check the status of your financial aid if necessary
Step 4: Register for classes• May be done online or at the campus.
Step 5: Cashier• Pay tuition and fees, discuss payment options and obtain your class schedule
• Payments may be made by money order, check, Visa, MasterCard, Discover, AmericanExpress, or ATM debit transfer.
Step 6: Photo ID Card• Obtain official college ID card and parking permit.