INDIVIDUAL COURSE APPLICATION

Welcome to The College of Westchester Application.  Completing and submitting this online application will initiate the process of applying to CW. If you have any questions or problems, don't hesitate to call us at 855.403.7722 or 914.559.2398 or email us at admissions@cw.edu.
(All Fields marked with * are required.)
Contact Information
Title:
First Name: *
Last Name: *
Maiden Name:
Street Address: *
Apt/Address Line 2:
City/State/Zip: * * *
Country:
Phone:
(Cell or Home required)
*
Phone 2):
Other Phone:
E-mail Address: *
Social Security Number:
May we contact you via text messaging?
Personal Information
Date of Birth: *
Gender: *
Marital Status:
Citizenship Status: *
Do you consider yourself to be Hispanic or Latino?
Regardless of your answer to the prior question, please select the ethnicity that best describe you:
Do you consider English to be your first language?
Education Information
Highest level of education completed/attempted: *
High School Education
Will you/do you have a High School diploma or GED?
*
When did or will you graduate from High School? * *
High School State:
High School City:
High School Name:
Emergency Contact
(Contact Name and 1 phone # required)
Emergency Contact:






Individual Credit Course Program

(Please select only one ICC Program for which application is made)

JumpStart Programs

Non-Discriminatory Policy

THE COLLEGE OF WESTCHESTER’S NONDISCRIMINATION POLICY PROHIBITS DISCRIMINATION IN ALL AREAS OF ITS OPERATION. THE COLLEGE OF WESTCHESTER DOES NOT LAWFULLY DISCRIMINATE AGAINST ANY PERSON ON THE BASIS OF RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, HANDICAP, VETERAN STATUS OR SEXUAL ORIENTATION. THIS IS IN COMPLIANCE WITH THE REGULATIONS AND POLICIES OF AFFIRMATIVE ACTION, TITLE IX AND SECTION 504 OF THE REHABILITATION ACT OF 1973.

Today's Date: 9/24/2017

College Catalog and Addenda

The College of Westchester’s College Catalog and Addenda are available at www.cw.edu/cwcatalog

I ACKNOWLEDGE I HAVE RECEIVED AN OFFICIAL COLLEGE CATALOG OR HAVE RECEIVED INFORMATION ON HOW TO ACCESS THE COLLEGE CATALOG ONLINE.

Attestation

I HEREBY APPLY FOR ADMISSION TO THE COLLEGE OF WESTCHESTER AND CERTIFY THAT THE INFORMATION I HAVE PROVIDED IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

I Agree