New Academy College Admission Application

Under Implementation

Academy College Admission Application

PERSONAL INFORMATION

Last Name

First Name

Middle Name

Birth Date

Social Security No

Street

City

State/Province

Zip/Postcode

Cell Phone

I AGREE TO ACADEMY COLLEGE CONTACTING ME VIA SMS MESSAGING

PLEASE INDICATE YOUR STATUS

U.S Citizen

Permanent Resident

Neither

Gender

Ethnicity

ARE YOU A VETERAN?

Yes No Not Selected

WILL YOU BE APPLYING FOR VETERANS BENEFITS?

Yes No Not Selected

HOW DID YOU FIND US?

WILL YOU BE TRANSFERRING ANY COLLEGE CREDITS?

Yes No Not Selected

SAT OR ACT SCORE IF APPLICABLE:

PROGRAM SELECTION

Program

Program Start Date

APPLICATION FEE AND ACCEPTANCE OF TERMS

An application fee of $40 must accompany this completed application. Please have transcripts from any schools listed on this application form forwarded to us a soon as possible. Notwithstanding anything to the contrary, all tuition, fees, and other charges shall be refunded to students if written notice of cancellation is given within five (5) business days after the day on which the student application is accepted by the school, which is the day it is received, regardless of whether or not the program has started.

School Catalog Received

SIGNATURE OF STUDENT

DATE

Under 18?

Yes No Not Selected

IF UNDER 18 YEARS OF AGE, SIGNATURE OF GUARDIAN

Relationship

DATE

Guardian Name

EMERGENCY CONTACT INFORMATION

Contact Name

Cell Phone

Relationship

Enter the above code

Required