STUDENT TYPES

Check all boxes that apply

� New Student �Guest Student �Virtual Learning Collaborative

�Returning Student �Transfer Student �Tech Prep

When do you plan to enroll? � Summer 20 _____ � Fall 20 _____ � Spring 20 _____

Preferred Campus �Downriver �Downtown � Eastern �Northwest �Western

Preferred Program Code ________________________________________ � Associate’s �Certificate � Selected Courses(See Insert) Degree Only

PRIOR ACADEMIC HISTORYList the last or current high school attended and all colleges, universities or other post-secondary educationalprograms attended.

NAME (S) OF HIGH SCHOOL (S), COLLEGE (S) OR GED CENTER GRADUATION DATE(Attach additional sheets if necessary) MONTH DATE YEAR

Did you graduate from high school? � Yes � No

Name of High School

City & State

GED � Yes � No

Did you take Tech Prep classes in high school? � Yes � No

If yes, which center?

College/University

Name of College or University

City & State

STUDENT'S SIGNATUREI certify that all information on this form is complete and accurate. I understand that falsifying any partof this application may result in cancellation of admission, registration or both. If admitted to Wayne CountyCommunity College District, I will become knowledgeable of all College policies and regulations and willabide by them.

Student's signature Date

Form 101 - 9/93, 4/94, 3/96, 7/99, 2/00, 11/03, 5/06 - 50000HDM, 7/2008

Wayne County CommunityCollege District

www.wcccd.edu

Application for Admission

Downriver21000 NorthlineTaylor, MI 48180-4717734-946-3500

Downtown1001 W. Fort St.Detroit, MI 48226-3001313-496-2758

Eastern5901 ConnerDetroit, MI 48213-3457313-922-3311

Northwest8200 W. Outer DriveDetroit, MI 48219-3580313-943-4000

Western9555 HaggertyBelleville, MI 48111-1404734-699-7008

NOTICE OF NON DISCRIMINATION - Any questions concerning Title IX of the Education Amendments of 1972 which prohibits discrimination on the basis of sex, or inquiries related toSection 504 of the Rehabilitation Act of 1973 which prohibits discrimination on the basis of handicap, and inquiries related to Title II of the Americans with Disabilities Act (ADA) whichprovides comprehensive civil rights protection for individuals with disabilities, or the College’s Statement of Compliance with Federal and State law, should be directed to HumanResources, Wayne County Community College District, 801 W. Fort, Detroit, MI 48226 or by calling: 313-496-2887.

LAST FIRST MIDDLE

CURRENT ADDRESS AND PHONE NUMBERS

NUMBER & STREET P.O. B0X OR APARTMENT

CITY STATE ZIP CODE

•

HOME TELEPHONE NUMBER

• •

M M D D Y Y

• • • •

SOCIAL SECURITY NUMBER DATE OF BIRTH GENDER

� FEMALE � MALE

Are you a veteran? � Yes � No

V.A. certificate#

PLEASE INDICATE YOUR RACIAL ORETHNIC HERITAGE:

Are you a resident in theWCCCD District? �Yes � No

County of residence

How long have you lived there?

RESIDENCYStudents residing in the College District will be charged residenttuition rates.The College District is defined as the whole of WayneCounty with the exception of the following cities and townships:Dearborn, part of Dearborn Heights, Garden City, Highland Park,Livonia, Northville, Plymouth and part of CantonTownship.Residency will be verified by voter registration card, driver's license,tax or rent receipts, or state identification card.

Are you a U.S. Citizen? �Yes � No

Country of Citizenship

Country of birth

Type of Visa

Date of Visa

Visa #

If you are a Naturalized U.S. Citizen, submit a photocopy ofyour Alien Registration Card with this application.

� African American(Non Hispanic)

� American Indian/Alaskan Native

�Caucasian (Non Hispanic)

� Asian/Pacific Islander

� African

� Hispanic: Puerto RicanMexican-American, Cubanand other Latino Cultures

� Arabic/Middle Eastern

� Other

� No response

Is English your second language? � Yes � No

If yes, what is your primary language?

This section is optional and will not be considered indetermining admissibility. Federal regulations do requireWCCCD to report this.

Wayne County Community College District

APPLICATION FOR ADMISSION

E-MAIL ADDRESS

WELCOME STATEMENT

WELCOME toWayne County Community College District. Our mission is to empower individuals, businesses

and communities to achieve their goals through excellent and accessible services, culturally diverse

experiences, and globally competitive higher education and career advancement programs.

Wayne County Community College District offers an affordable, quality education for today and tomorrow.

ADMISSIONS PROCEDURESNEW STUDENTSAdmission to Wayne County Community College District is “Open Door”; it is automatic for those who are 18 or

older. Admission to specific programs is not automatic. New students are required to complete this Application for

Admission and submit it to the District Office of Admissions at 801 W. Fort St., Detroit, MI 48226. For those under

18 years of age, the possession of a high school diploma or approval of a parent or guardian is required to

accompany the Application for Admission.

Current high school Juniors and Seniors may apply for enrollment in WCCCD classes by completing the Dual or

Concurrent Enrollment form along with submitting written permission from a parent or guardian and the high

school principal. This form should be submitted to the Office of Admissions. Persons under age 18 must resubmit

the Dual or Concurrent enrollment form and be approved for each semester for which they intend to enroll

regardless of previous enrollments.

Step 1: Apply for Admission• Complete and submit the Application for Admission. Returning students (students who have

not attended WCCCD in two or more years) should complete the admissions application andsubmit transcripts of previously attended colleges/universities.

• Take the placement test (COMPASS) in the testing room at the campus of your choice.

Step 2: Meet with an Academic Advisor• Discuss assessment results.

• Discuss and explore your course options, educational goals and develop an educational plan.

• Activate your PIN so you can register online through Web-Gate

Step 3: Check the status of your financial aid if necessary

Step 4: Register for classes• May be done online or at the campus.

Step 5: Cashier• Pay tuition and fees, discuss payment options and obtain your class schedule

• Payments may be made by money order, check, Visa, MasterCard, Discover, AmericanExpress, or ATM debit transfer.

Step 6: Photo ID Card• Obtain official college ID card and parking permit.