College Credit Plus Student Admissions Application Step 1 of 3 33% Personal InformationAll fields in this section are required.Name* First Middle Last Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Cell Phone*Text Messages I will accept text messages from Chatfield Date of Birth* Date Format: MM slash DD slash YYYY Email Address* Preferred CampusSt. Martin CampusCincinnati CampusParent's Name First Last Parent's PhoneParent's Email Address Emergency Contact Name* First Last Emergency Contact Phone Number*Optional InformationWhat is your religious preference?Are you Hispanic or Latino?YesNoWhat is your ethnicity?You may check one or more of the following. African American/Black American Indian, Alaskan Native Asian Caucasian/White Native Hawaiian or other Pacific Islander GenderMaleFemaleChatfield College subscribes to Equal Opportunity/Affirmative Action guidelines and does not discriminate in its education programs or activities on basis of race, color, creed, sex, national origin or handicap, in accordance with both Title IX of the 1972 Education Amendments and Section 504 of the Rehabilitation Active of 1973. BackgroundAll fields in this section are required.Name of High School*High School City/State* City State / Province / Region Graduation Year* Date Format: MM slash DD slash YYYY Entrance InformationAll fields in this section are required.Desired Month of Enrollment*Fall (August)Spring (January)Summer (June)Desired Year of Enrollment*Classification*Part-TimeFull-TimeApplication Status*ApplicantTransfer ApplicantReturning StudentNon-Degree Seeking StudentConsortium StudentCCP StudentI am a Veteran, but never attended a college/universityI am a Veteran with transferrable college creditTranscript Requirement: High school and GED graduates must submit official transcripts to the Admissions office. Degree seeking students who have attended other colleges must submit official transcripts from those colleges. Note: Students who plan to audit classes and not receive credit are not required to submit transcriptsIntended Concentration*Marketing / Public RelationsWhat other colleges are you interested in? (optional) Of the following, which did you use to learn about Chatfield College? Alumni Brochure Chatfield College Admissions Counselor Chatfield College Faculty or Staff Member Chatfield College Website College Fair Current Student Facebook / Twitter Friend or relative High school teacher High school guidance counselor Internet Search Visit to Campus TV Radio Billboard Chatfield College has permission to use my name and related information if my application is accepted.*YesNoNote: By completing and submitting this application, students who attend Chatfield give the College permission to use his/her photographs and/or digital media for marketing purposes, both on the website and in print materials. The photographs and digital media become the property of the College and are only used to promote Chatfield. I certify that the information contained in this application is true and correct. I understand that misrepresentation or omission of information, such as failure to list all schools, colleges, or universities attended, may result in the denial of this application or subsequent dismissal from the college and loss of credit.