Application for Admission


Application Procedure

To be admitted each student must submit a completed
Crowder College Application for Admission and a $25 application fee.

Enrollment in classes is subject to receipt of transcripts and your
academic status. Please refer to the online catalog or visit the admissions
office at Crowder College.


If you need special accomodations, please contact
the Dean of Student Services, 417-455-5636

Associate of Arts degree - These degrees are designed to transfer to a four-year college or university for the completion of a baccalaureate degree in the arts and science.

Associate of Science degree - These degrees have specifically tailored general education components for the student pursuing a degree in a science related field.

Associate of Applied Science degree - The AAS degree allows students to focus their study to a specific field, and is not designed to transfer to a four-year school, although some programs and classes do transfer, depending on the institution.

Certificates - The certificate programs provide skills training and are generally completed in one year or less.

Crowder College Student Self Identification Report


We consider all applicants for admission without discrimination based on race, color, religion, sex, national origin, age, veteran/reserve/national guard or any other similarly protected status.

To assist Crowder College in its effort to comply with federal and state requirements regarding government record keeping, reporting and other legal obligations, we invite you to supply the following information. Providing this information is strictly voluntary. Failure to provide it will not subject you to any adverse decision or action or denied admission to Crowder College. Your cooperation is appreciated.

Please be advised that this report is not a part of your official student application. The information will be kept confidential in accordance with applicable laws and regulations.

Student Information:

Name: ---Social Security Number (Optional):
Please check the correct information: Gender: Male Female----- Birth Date:

Please check all that apply below. Are you:
A Vietnam Era Veteran
I am a veteran of the Vietnam era; I served on active duty for more than 180 days, some part of which occurred between August 5, 1964, and May 7, 1975, and I was discharged with other than dishonorable discharge, or I was released from active duty for a service-connected disability during the same period.

Disabled Veteran
I am a disabled veteran; i.e., I am entitled to disability compensation under the laws administered by the Veterans Administration for a disability rated at 30% or more, or I was discharged or released from active duty for a disability incurred or aggravated in the line of duty.

First Generation
I am an individual whose parents did not complete a 4-year college degree; or an individual who resided primarily with only one parent and that parent did not have a 4-year degree.

Disabled
I am a disabled person; i.e., I have a physical or mental impairment which substantially limits one or more of major life activities.

Non-Resident Alien
A person who is not a citizen or national of the United States and who is in this country on a visa or temporary basis and does not have the right to remain permanently.		 Black (Non-Hispanic)
A person with origins in any of the black racial groups of Africa who is not of Hispanic origin.

American Indian or Alaskan Native
A person with origins in any of the original peoples of North America or who maintains cultural identification through tribal affiliation or community recognition.

Asian or Pacific Islander
A person with origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes China, Japan, Korea, the Philippines, Republic, India, Vietnam, and American Samoa.

Hispanic/Latino
A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture of origin regardless of race.

White (Non-Hispanic)
A person with origins in any of the original peoples of Europe, North Africa, or the Middle East who is not of Hispanic origin.


OFFICIAL APPLICATION

First Semester Enrolled:
Fall - --Year
Spring - --Year
Summer - --Year

I. PERSONAL INFORMATION
(to be completed by all students)

Complete Legal Name:
Last --First --Middle

Former Names (if any):

Social Security Number: --Date of Birth:

Marital Status: Married Single
 Gender: Female Male

Personal Email Address

Mailing Address
Street Address
City --State --Zip Code
(Area Code) --Phone Number --
Secondary Phone No. (Area Code) --Phone Number

Permanent Address:
Street Address
City --State --Zip Code
County in which you reside --
School District in which you pay property taxes
How long have you lived at your permanent legal address? --years --months
Race: (Optional) Hispanic/Latino White Black/African American Asian American
Hawaiian Native/Pacific Islander American Indian/Alaska Native Other

Citizenship: U.S. Permanent Resident Alien Other Please Specify:


Native Language: English Other

II. EDUCATIONAL INFORMATION
Student Status: First time student at any college (FT)
Former student at Crowder College (FR)
Have you attended another institution since attending Crowder? Yes No
Transfer student (prior credit at another institution but first time at Crowder College) (TR)
Transient Student (non-degree seeking at Crowder; taking one class to transfer to another institution) (TS)

Classification: Freshman (0-30 hours) (FR) Sophomore (0-30 hours) (SO)
Post Junior College (65+ hours) (PJ) Post Baccalaureate (PB)
Special (no GED or High School Diploma) (SP) High School Student (HS)
(expected grad year: )

HIGH SCHOOL/G.E.D. INFORMATION (CHECK ONE)

HS Graduation Date: Month ---Year



High School (If "Other" was chosen): ---City ---State
GED 999998- -Date Completed GED: ---Month --Year --State Received: -
999996 Home School
999999 Non Graduate
Have you completed the requirements for the Missouri High School A+ schools program? Yes No


COLLEGE INFORMATION


List all colleges and/or universities which you have attended. Official transcripts of all degree-seeking students are required to be on file by the fourth week of the semester.
Name of School
City/State

Program of Study: (Please choose ONE)

III. EMERGENCY INFORMATION


Person to contact in case of an emergency:
Name: ---Phone Number:

Name of physician and phone number of hospital you wish to be transported to in case of an emergency:
Name: ---Phone Number:

In case of an emergency, I authorize college personnel in charge to use their discretion regarding the college's emergency procedures. I understand that falsification of any information provided on this application will subject me to disciplinary action, which may result in my dismissal from the college.
Name: ---Date:

IV. REMINDER AND INFORMATION


To assist in processing your application promptly, be sure to mail or fax all necessary documentation (official copies of your academic records, test scores) to:

Admissions Office
Crowder College
601 Laclede
Neosho MO 64850

Or fax records to 417-455-5731


The $25 application fee is also due at this time. You may mail a check, made payable to Crowder College, to the address above.

Your application will be held until receipt of all documents is complete. Materials become the property of Crowder College and cannot be forwarded elsewhere.

I certify that the answers given in this application are complete and accurate to the best of my knowledge, and I understand that submission of false information may result in my denial or suspension.

Name: ---Date:

In the absense of a written signature, if you agree to the above terms, please select the SUBMIT button.