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    Summer - Winter New Student Application

    Uploaded by

    Amanda Labbe
    1) Gateway Community College is accepting applications for their summer/winter semester classes. 2) There is a $20 non-refundable application fee, unless the applicant has attended another Connecticut community college. 3) The application requests basic contact and background information from applicants such as name, address, citizenship status, gender, race, previous education history, and signature agreeing to comply with college rules.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Summer - Winter New Student Application

    Uploaded by

    Amanda Labbe
    40 views1 page
    1) Gateway Community College is accepting applications for their summer/winter semester classes. 2) There is a $20 non-refundable application fee, unless the applicant has attended another Connecticut community college. 3) The application requests basic contact and background information from applicants such as name, address, citizenship status, gender, race, previous education history, and signature agreeing to comply with college rules.

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    Summer_ Winter New Student Application

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    1) Gateway Community College is accepting applications for their summer/winter semester classes. 2) There is a $20 non-refundable application fee, unless the applicant has attended another Connecticut community college. 3) The application requests basic contact and background information from applicants such as name, address, citizenship status, gender, race, previous education history, and signature agreeing to comply with college rules.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    40 views1 page

    Summer - Winter New Student Application

    Uploaded by

    Amanda Labbe
    1) Gateway Community College is accepting applications for their summer/winter semester classes. 2) There is a $20 non-refundable application fee, unless the applicant has attended another Connecticut community college. 3) The application requests basic contact and background information from applicants such as name, address, citizenship status, gender, race, previous education history, and signature agreeing to comply with college rules.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Application Fee Only

    Long Wharf Campus Master Card / Visa Only:


    60 Sargent Drive
    New Haven, CT 06511 ____________ / ____________ / ____________ / ___________
    (203) 285-2010 Expiration Date: ______________________________________
    Fax (203) 285-2260
    20.00
    Amount Not to Exceed: $ ______________________________

    ___________________________________________________
    Signature

    Summer/Winter New Student Application


    GATEWAY COMMUNITY COLLEGE
    STATE OF CONNECTICUT
    BOARD OF GOVERNORS FOR HIGHER EDUCATION
    BOARD OF TRUSTEES OF COMMUNITY-TECHNICAL COLLEGES
    New students to Gateway Community College registering for credit courses for the summer/winter classes must complete an Application for Admission.
    There is a $20 non-refundable Application Fee. You need not pay this fee if you have attended another Connecticut Community College.
    Former Gateway students (continuing/readmit students can go directly to the Registrar’s Office to register.)
    For those new students interested in continuing in the fall and spring semesters,
    please contact the Admissions Office at (203) 285-2010 for further information.

    Semester: Summer _________________ Winter _________________

     New Student

    Last Attended ______________________________________________________ Student I.D.@ ______________________________________________

    Applicant’s Legal Name __________________________________________________________________________________________________________


    Last First Middle

    Former Last Name (s) ___________________________________________________________________________________________________________

    Social Security Number (required by Federal Law) ___________- ___________- ___________ Birth Date ____________ - ____________ - ___________
    MM DD YYYY

    Mailing Address ________________________________________________________________________________________________________________


    No. and Street City State Zip

    Permanent Address _____________________________________________________________________________________________________________


    No. and Street City State Zip

    Telephone Home (_____)___________________________ Work (_____)___________________________ Cell (_____)____________________________


    Area Code Area Code Area Code
    Please provide ethnic and race data. This information is requested on a voluntary basis by the U.S. Department of Education, National Center for Education
    Statistics (this information will not affect your admission to the College).

    ETHNICITY:
     Hispanic/Latino  Non-Hispanic/Non-Latino  Choose not to respond (None)

    RACE: (More than one race can be selected as applicable.)


     White (10)  Black (20)  Asian (45)  American Indian or Alaskan Native (50)
     Native Hawaiian or Other Pacific Islander (80)  Other (90)  Choose not to respond (60)

    Connecticut Residency:
    Are you a legal resident of Connecticut?  Yes  No
    Connecticut law requires that a student be a citizen or permanent resident living in Connecticut for 12-months prior to the beginning of the semester to be
    eligible to receive in-state tuition.

    Gender:  Male Citizenship:  U.S. Citizen  Non U.S. Citizen On Student Visa (F1)
     Female  Permanent Resident  Non U.S. Citizen Not on Student Visa - Type of Visa ( )
    Academic Background:
    Do you have a high school diploma? Yes No Pending Graduation Year (anticipated or actual) __________________________________
    Name of high school ________________________________________Town ___________________ State __________________ Country ____________
    Do you have a general equivalency diploma? (GED) Yes No Year _____________ GED # __________ Town/ State ______________________

    Previous College Background:


    College/ University Name State Dates of Attendance Graduation Date
    _____________________________________________________________________________________________________________________________
    _____________________________________________________________________________________________________________________________

    It is the policy of Gateway Community College that no person shall be excluded from participation in, denied the benefits of, or otherwise discriminated against under any
    program, including employment, on the basis of race, color, religious creed, sex, age, national origin, ancestry, present or past history of mental disability, genetic information,
    marital status, mental retardation, sexual orientation, learning disability, pregnancy, physical disability, including, but not limited to blindness, or prior criminal record,
    political beliefs, or veteran status.

    Applicant’s Statement:
    If admitted, I pledge to comply with all the rules and regulations of the College. I realize that
    _______________________
    any misleading information on this application may be cause for dismissal. _____________________________________________________________
    Student’s Signature Date

    REV. 05/08

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