APPLICATION FOR ADMISSION


To complete this Online Application for Admission, fill out all fields below.  Use the Tab key on your keyboard to move between fields. If some of the fields do not apply to you, do not enter any data.

Students who wish to reserve a room in one of the residence halls must complete a Residence Hall Application.   Mail the application and the required application fee to Cisco College, Housing Office, 101 College Heights, Cisco, Texas 76437.


This is required information.
I. Identification Information

NOTE:  In order to apply electronically, the applicant's Social Security number must be provided.

Social Security Number
(Example: 123456789)
RE-ENTER Social Security Number
EMail Address
(Example:johndoe@somewhere.com)

 

II. Personal Demographic Information

       

Name

  
First Name 


    Middle Initial


     Last Name

       


Maiden or Other Name

   

Address


Address Line 1

 
     
 


Address Line 2

   
 
 


     City


  State


     Zipcode

 
  County
 
  Country
 
       

Telephone   Number


Telephone
(Example: 9185551234)

       
       

 

III. Request for Confidential Information


The information requested below will be treated as confidential and will be used for summary reports required by federal and state laws and regulations and to support institutional affirmative action efforts. It will not be used as a basis for admission or in a discriminatory manner.

Date of Birth


(MMDDYYYY)

   
       

Gender

Ethnic Background

 

Marital Status    

Are you a US Citizen?

   
   If not, give type of U.S. visa held or to be obtained
  Date of Issue
  
   

Are you a legal resident of Texas? 

   

Upon whom are you basing your claim of residence status?
Self
Parent
Legal Guardian
   

Are you a Veteran? 

   
   If yes, do you receive VA benefits?  

Are you active military?

   
       

Are you a military dependent?

   
       

 

IV. Educational  Information

Are you entering college for the first time?

   
   If no, enter last college attended
 


 

Your student classification will be:

This application is for

      of     20

   

Will you be attending high school while enrolled at Cisco College?

   

What is your intended Program/Major? Non credit students please choose Non credit

   

What is your educational intent?

(Only degree and/or certificate-seeking students are eligible for Federal/State Financial Aid.)

 

Which campus do you wish to attend?

If you have a physical or learning disability that may require special accomodations, please contact the Special Populations Coordinator at the location you plan to attend. The Special Populations Coordinator at the Cisco Campus may be reached at 254-442-5023. The Abilene Center Special Pops Coordinator may be reached at 325-794-4406

   

 

V. Educational Background

High School Name

 


City


State 

High School graduation / GED date
(Example:02)
 
   

Are you a former Cisco College student?

   
   

I certify that the information provided in this Application for Admission is complete and accurate to the best of my knowledge. I further understand that this information will be relied upon by the officials of the college in determining my admission and residence status for tuition purposes and that the submission of false information is grounds for rejection of my application, withdrawal of an offer of acceptance, cancellation of enrollment, and/or disciplinary action. I agree to conform to and abide by the letter and the spirit of all policies, rules, and regulation of Cisco College.

I authorize Cisco College to electronically access my Texas Higher Education Assessment test results to be used for required course placement. If I have taken an alternative test (Accuplacer, MAPS, ASSET, or COMPASS), I understand I must provide official test scores from my alternative test for required course placement.

Admission to Cisco College is open to all qualified persons regardless of race, creed, color, sex, handicap, age, religion or national origin.

When you have completed the Online Application for Admission, click the "Submit" button ONE TIME ONLY.

  


[ Return to the Summary of Admissions Procedures Page ]

 

Serving the Big Country with Locations in Cisco and Abilene!

Cisco College • 101 College Heights • Cisco, Texas 76437 • P 254.442.5000 •
All contents of this site copyright © 2001 Cisco College. All Rights Reserved.