We are excited you want to be a Seawolf! 

This application is for:

· New students applying to SMCC for a degree or credit certificate program

· Returning students that have been gone for more than 3 years (if you've been gone less than 3 years click here)

· Current students applying for a competitive health science program (Cardiovascular Technology, Nursing, Paramedicine, Radiography, and Respiratory Therapy)

If you are interested in:

· Workforce development programs, please click here

· Just taking a class or two, please click here

Let's get started! 

What is your goal for attending SMCC?

Select One:

What Program are you applying to?

When would you like to start?

I intend to eventually transfer to USM and wish to participate in the SMCC-to-USM Transfer Program.  I consent for SMCC to share with USM my intent to participate in the program, contact information, and intended academic major, and expected graduation date.  (I understand that USM will provide me with information on the academic transfer pathways that relate to my intended major, the numerous scholarship opportunities available for transfer students, and how to streamline my admission to USM)

Are you a current SMCC student applying for a health science program?

My Contact Information

Name

Legal First Name:

Preferred First Name:

Confirm that you want to use this name across campus to include class rosters, student email, student ID, user login, and more.

Middle Name/Initial:

Legal Last Name:

Maiden/Birth/Other Last Name

Address

Street Address/P.O. Box #/Apt #:

City:

County:

State:

Zip/Postal Code: 

Email Address:

Confirm Email Address:

Telephone Number(s)

Home Phone #:

Cell Phone #:  

My Personal Information

Date of Birth (MM/DD/YYYY):

Social Security Number:

We respect your privacy. Access to your SSN will be restricted, but is needed for evaluating eligibility for federal financial aid.

Qualifications

Of all of the schools/colleges/universities you have attended what is the highest degree you will/have earned?

High School 

Date of/Anticipated high school graduation (MM/DD/YYYY): (Give your best guess)

High School Attended/Attending or Where You Took Your GED/HiSet Exam:

High School City:

High School State:

Did you participate in the following while in High School? (choose all that apply)

Did you attend a vocational program (CTE) while in high school (Maine Residents Only)?

What was your vocational center?

What was your program of study?

How many years of vocational programming did you complete?

College/University

Please list previous colleges/universities you have attended.  You must submit an official transcript for each college listed.

College/University Attended:

State:

City:

Please answer the following questions as they are either required by federal agencies or will help the college identify possible qualifications for additional support services or resources.

The federal government requires SMCC to report gender as either male or female. 
Please select the gender you most identify as:

I identify my gender as:

Other Gender:

What are your preferred gender pronouns?

Other Pronouns:

Residency (choose one):

I have lived in Maine since (MM/DD/YYYY):

What is your citizenship status?

If you are not a U.S. citizen, what country are you a citizen of?

Are you an international student that needs SMCC to issue an I-20 for your F1 Visa? 

Race (choose all that apply):

Nation/Tribe?

Ethnicity (choose one):

Are you a dependent of a Veteran?

What is your relationship to the Veteran?

Are you currently serving or have you served in the US Military?

I am currently active duty:

I am currently a veteran:

Which branch of the US military?

Do you plan on using VA benefits?

Will you be working while taking classes?

How many hours per week do you think you will be working?

Highest Level of Education Completed by Parent/Guardian 1:

Highest Level of Education Completed by Parent/Guardian 2:

Verification

Records Release Consent:

I consent that my high school may release my educational record (transcripts, immunizations, etc.) to SMCC as part of this application process.

Student Signature:

By selecting 'Yes' and typing your initials below, you hereby certify that the information entered into this form is true and correct to the best of your knowledge and agree that SMCC may contact you through the various means provided in this application for reasons including but not limited to your classes, bills, major, etc. 

I agree:

 Initials:

You will not be able to submit this application form until you select 'Yes' above.

Parent/Guardian Signature:
(required only if the student is under 18)

By typing your name in the 'I agree' field below, you acknowledge that your student is applying to Southern Maine Community College. 

I agree: