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For online submission only. * indicates required items |
Birthdate: |
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*Last Name: |
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*First Name: |
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Middle Initial: |
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*Street Address: |
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*City: |
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*State: |
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*Zip Code: |
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Country: |
(if other than United States) |
*Home Telephone Number: |
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Work Telephone Number: |
Extension:
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Cell Phone: |
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E-mail Address: |
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Have you attended Jefferson College previously?
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Have you attended another College?
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*Are you a high school graduate or GED recipient?
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If high school graduate, please enter high school name:
State:
Graduation Year:
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If GED recipient, please enter month/year GED Earned:
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| When do you plan to begin taking classes at Jefferson College?
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| What do you plan to study?
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What materials may we send you? |
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Application for Admission |
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Compass Test Information (pertains only to student's who have not taken the ACT) |
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Academic Brochure - Please list major areas of interest:
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Nursing Information - Please indicated Program:
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Other:
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| Click below for materials you may access online: |
| Catalog |
| Class Schedule |
| FAFSA |
Scholarship Application |
| Student Housing |
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Other:
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| Questions or Comments:
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