Baltimore City Community College
Admissions Application

LIBERTY CAMPUS
2901 Liberty Heights Avenue
Baltimore, MD 21215-7893


Directions: Please complete the admissions form below. When you have completed the form, click on the SUBMIT button at the bottom of the form. If you have not answered any required questions, a message will be displayed describing the missing data.


Completion of the Maryland Residency Form and appropriate documentation is required for in-state tuition.

Create Your PIN:(4 characters)

Social Security Number:

Name:

First Name
Middle Name
Last Name
Suffix (Jr, Sr, III)

Current Address

Street Address
Apt/Suite
City, State Zip  

Birthdate:     

Home Telephone () -
Work Telephone () -

Email Address

In case of an emergency, call
  Name Relationship
  Home Telephone Work Telephone

Gender Male Female
Is your cultural background Hispanic or Latino Yes No Undeclared
Racial/Ethnic Category (for statistics only) (Select all that applies)
  African American or Black American Indian or Alaska Native
  Asian White
  Native Hawaiian or Other Pacific Islander Other Undeclared
Have you been a Maryland Resident for 3 months or longer? Yes No
Permanent Residence Baltimore City
  Maryland County: 
  Out of State
  International
U.S. Citizen? Yes No   Country of Citizenship
  If not US Citizen, Type of Visa   Alien Registration Number
Is English your principle language? Yes No
Military: Active Duty Veteran Reservist Not Military
Are you applying for Veterans' education benefits? Yes No

Student Status New Student-Never attending another college
  Transfer Student-Previously attended another college
  Returning Student-Attended BCCC as credit student more than 1 year ago
  Non-Degree/Attending Another College Student
  High School School: Attending BCCC and also attending high school
  International Student: Applying for Student (F-1) Visa
Instructional Program ("Major")   Special Entry Major
Semester Applying for
Admission Status Full Time Student (12 credits) Part Time Student (1-11 credits)
Academic Objective at BCCC Associate Degree Certificate Taking Courses to transfer Taking Courses
Which of the following goals do you hope to achieve from your studies at BCCC? (Check all that apply)
  Explore new career(s) Prepare for immediate entry into a career
  Prepare for transfer to a 4-year institution Update skills for my current job
  Pursue personal interest and self-enrichment Other

High School/GED High School Diploma Graduation Date
    MD High School Diploma (GED) Date
  High School/GED Other
>
Select all colleges attended, including BCCC, either full- or part-time.
  School Name
  Other
  From   To  
  Degree/Certificate Received Date
 
  School Name
  Other
  From   To  
  Degree/Certificate Received Date
 
  School Name
  Other
  From   To  
  Degree/Certificate Received Date

Employment Status     When you start classes, how many hours do you expect to be employed per week?
                        (Enter 0 if not planning to be employed)
Has either of your parents received a Bachelor's degree? Yes No
How did you hear about Baltimore City Community College? (check all that apply)
  School Counselor BCCC Admissions BCCC Publication Newspaper Billboard
  Radio Television Friend Internet Other  

Please read: To the best of my knowledge, every statement I have made on the Admissions Application is correct. I realize that deliberately falsifying or omitting information could be grounds for dismissal from the College. I understand that it is my responsibility to notify the Admissions or Registrar's Office of any changes in this information. I accept and agree to abide by all policies and regulations of BCCC including those concerning drug and alcohol abuse. I understand that the unlawful use of drugs or alcohol will subject me to the penalties contained in those policies and regulations.

I agree to submit an official high school transcript showing date of graduation or an official Maryland High School Diploma (GED) or high school diploma-equivalent from another state.


Do you agree ?
Yes No