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Application for Admission


Please note: The Application for Admission Form is for new students only.
Returning students should fill out the Returning Student Update Form.

 Personal Information * These fields are required     + See note
1. *
U.S. Social Security Number: --
NOTE - Without your Social Security Number, Macomb cannot award financial aid or provide tuition information for Federal Tax credits.
2. +
Date of Birth:
    NOTE - Date of Birth is required to use web registration.
3. +
Gender:
Male Female
4. +
Ethnic Origin: Hispanic/Latino Non-Hispanic/Latino
   
4a. In addition, select one or more of the following racial categories to describe yourself:
 
American Indian  or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
 
5. *
I plan to enroll starting:
6.  
Name:

*Last

*First
 Middle

Suffix

 
   

Former Last

    NOTE - Provide us with your full name as it appears on your social security card.
7.  
Address: *Home

*State

*Zip

   
  *City
    NOTE - Provide us with your address as it appears on your driver's license using only the first five digits of U.S. zip codes.
8. *
Primary Phone:
-- Business  Cell  Home 
 
Secondary Phone:
-- Business  Cell  Home 
9.   In case of an emergency or possible health related issue, please call:
   
Phone:
--  
Contact Full Name:
10.  
Email Address:
    NOTE - Email is needed to receive valuable college information regarding admissions, registration, financial aid, emergency closings, etc. Example: johndoe@gmail.com
11. *
Citizenship: United States of America Non-U.S. Citizen
   
11a. If Non-U.S. citizen, country of citizenship:
11b. Immigration status:  
 
F-1 Student Visa B Visitor Permanent Resident (Alien Number)
Refugee/Asylum     Other Visa (Specify Type)
NOTE - NON-U.S. CITIZENS ONLY: Must provide a copy of permanent resident card, copy of visa, or a copy of I-94 by mail, fax or in person. It must be received before your application can be processed.
12. *
Military Affiliation:
Veteran Spouse or Dependent of Veteran
Active Member of Military Spouse or Dependent of Active Member
National Guard/Military Reserves Spouse or Dependent of Guard/Reserves
None of the above    
13.  
Are you interested in applying for financial aid? Yes No

 Admission Status  
14. *
Will you be:  
Attending college for the first time Transferring from another college
Guest Student (currently attending another college and plan to attend Macomb for one semester) Personal Interest (Not planning on pursuing a certificate or degree)
 
15. *
What are your educational goals? (Check all that apply):  
Associate Degree Certificate
Personal Interest Transfer to a four year College or University
 

 Educational Background  
16.  
High School Last Attended Name:    
High School City:  State:
Highest Grade Completed:
9th 10th 11th 12th
Graduation Date:
Anticipated or Actual GED Date Certificate of Completion
   
16a. Are you a home school student? Yes No
16b. If yes, do you certify that you have completed your secondary school education in a
  home school setting? Yes No
17. *
Have you attended another college or university? Yes No
   
17a. If so, please indicate for all: Name, City & State, Start & End Dates (Month/Year)
 
* I certify that all of my responses are true to the best of my knowledge. I understand the policies and procedures in the college catalog, schedule of classes, and on the website (www.macomb.edu) are the official source of information for Macomb Community College.