First Name (required) Middle Name Last Name (required) Student ID # SSN Date of Birth (required) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006 High School (required) Projected High School Graduation Date (required) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2018201920202021202220232024 Plan/Major at WCC - None -Administration of JusticeAdministrative Support Technology AASAdministrative Support Technology: Health Information Management Specialization AASAdministrative Support Technology: Legal Assistant Specialization AASBusiness Administration AA&SBusiness Management and Leadership AASCarpentry CSCClerical Assistant CSCClerical Studies AASConstruction Technology: Carpentry Track DiplomaConstruction Technology: Alternative Energy Systems Track DiplomaConstruction Technology: Electrical Track DiplomaConstruction Technology: Heating, Ventilation and Air Conditioning (HVAC) Track DiplomaConstruction Technology: Plumbing Track DiplomaCorrections CertificateCorrections Science AASCybersecurity CertificateCybersecurity Fundamentals CSCDental Assisting CSCDental Hygiene AASEducation AA&SElectrical CSCElectronic Medical Records Specialist CSCEMS Emergency Medical Services AASEMT - IntermediateEMT - Paramedic (Intermediate)EMT- Intermediate to Paramedic BridgeFile Clerk CSCGeneral Education CertificateGeneral Studies AA&SGeneral Studies Communication/ Media Studies Specialization AA&SGeneral Studies Community & Provider Services Specialization AA&SGeneral Studies with a Developmental Disabilities Specialization AA&SGeneral Studies, Specialization in Health Science AA&SGeneral Studies Human Services Specialization AA&SGeneral Studies Substance Abuse Specialization AA&SHeating, Ventilation and Air Conditioning (HVAC) CSCHuman Services: Developmental Disabilities CSCHuman Services: Integrated Disipline CSCHuman Services: Mental Health CSCIncident Response and Digital Forensics CSCInformation Systems Technology AASInformation Systems Technology with Ethical Hacking and Penetration Testing Specialization AASLaw Enforcement CertificateLegal Assisting CSCMachine Technology AASMachine Tool Operations CertificateMachining CSCMedical Laboratory Technology AASMedical Coding CSCMedical Office Clerk CertificateMedical Records Clerk CSCMedical Transcriptionist CSCNetwork Technician CSCNursing AASNursing Bridge (LPN to RN)Pharmacy Technician CSCPhlebotomy CSCPhysical Therapist Assistant AASPlumbing CSCPractical Nursing CertificatePublic Health CSCScience AA&SScience Specialization in Computer Science AA&SScience Specialization in Engineering AA&SScience Specialization in Food Animal Production AA&SScience Specialization in Mathematics AA&SScience Specialization in Veterinary Preparation AA&SSolar Installer CSCSubstance Abuse CSCWeb Design and Office Applications CSC What term will you begin classes after high school? Semester (required) Summer (May) Fall (August) Spring (January) Year (required) - Select -2020202120222023 Cell/text number Home phone number Email address (required) Mailing AddressPO Box or Street (required) City (required) State (required) - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code (required) Please note by submitting this form you are acknowledging that it is your responsibility to request an official mid-year high school transcript after your first semester grades have posted if you are applying for a selective admission health program at WCC. This transcript must be received by the February 15th deadline to apply for admission to a health program for the following fall. All high school students must submit official high school transcripts that reflect final grades and a high school graduation date. If you have taken the SAT or ACT, you must request your scores from www.collegeboard.org. Test score reports must be official and cannot be accepted from any other source.