Admission Application www.tstc.edu

_________________________________________________________________________________________________ Last Name First Name Middle Name Suffix _________________________________________________________________________________________________ Mailing Address _______________________________________________________________________________________________________ City State Zip

Start Term: Fall Spring Year __________

_________________________________________________ Program/Specialization

Emergency Contact: __________________________

Home Phone:

Relationship:__________________

Cell Phone:

I allow TSTC to send text messages to my cell phone.

yes

Emergency Contact Phone:

no

Business Phone:

Educational Intent (check only one box):

Social Security Number:

Complete an Associate of Applied Science degree (1)

For Federal Income Tax purposes, IRS law requires that a student furnish a Social Security Number (SSN) to the collage allowing the reporting of tuition on the Form 1098T. If you do not have a SSN and you have applied for or intend to apply, check the “Applied For” box and provide your SSN to the college as soon as it is received. Applied For

Date of Birth:



Mo

Day

Complete a Certificate of Completion (2) Complete credits for transfer (3)

Year



The following information is for reporting purposes and in no way affects your admission or enrollment to TSTC. Your response is voluntary and will be used in a nondiscriminatory manner, consistent with applicable civil rights.

Are you Hispanic/Latino?

Yes

Race: (Select one or more races)

White (WH)

Black (BL)



Asian (AS)

Native Hawaiian or Other Pacific Islander (HP)

Gender:

Female

No

Male

Check location where you plan to take the majority of classes:

American Indian or Alaska Native (AN)



Country of Birth: _________________________________

Your Email Address is very important. Your records will remain confidential. If you do not currently have an email address, you must obtain one for use at TSTC.



Other Legal Names: _____________________________________________________________ High School Name

________________________________________________________________________________ State Zip

Private

Home School

Type of Award (check highest level completed) Diploma Year Received ____________________

Abilene (460)

Harlingen (200)

Breckenridge (480)

Sweetwater (400)

Brownwood (470)

Marshall (500)

Waco (100)

Red Oak (510)

Ft. Bend (130)

Have you ever been charged with a felony?

High School Attended:______________________________________________________________________

City

Complete courses to get a new or better job or to improve skills for current job (4) Complete courses for personal enrichment (5)

E-mail Address: ________________________________________________________________

Public

Summer

Yes

No

Current/Previous Military Service?

Yes

No

Eligible for VA Benefits?

Yes

No

Applying for Financial Aid?

Yes

No

Enrolling for Dual Credit?

Yes

No

GED Year Received ____________________

No Diploma Last Grade Completed ______________