First Name

Preferred First Name 

Please note: Students may identify themselves with a preferred first name in addition to their legal name.  The preferred first name will be on the student schedule, ID card, instructor's roster and Blackboard.  Students' educational records such as transcripts that require legal name will not be changed to preferred name.

Middle Name

Last Name

Suffix

Prior/Other Last Name

Email Address

Date of Birth (mm/dd/yyyy)

Social Security Number

Gender (M/F)

Address Line 1 - A P.O. Box is not accepted as a legal address.

Address Line 2 - P.O. Box, Apt., Suite, etc.

City

State

Zip Code

Resident of

Have you lived at this residence for three (3) months or longer?

If no, date of Cecil County residency - Use the 15th if you do not know the exact date.

Main Number

Cell Number

Military Service: (Select one box or leave blank if this question does not apply to you)

Emergency Contact's Full Name

Relationship

Emergency Contact's Phone Number

The Family Educational Rights and Privacy Act (FERPA) allows the Registrar to release student directory information. This information may include names, addresses, telephone numbers, Cecil College email addresses, birth dates, birth places, major fields of study, attendance dates, degrees and awards, the most recent educational agencies or institutions attended, participation in officially recognized college activities or sports, and athletic team members’ weights and heights. The College generally will release only the student’s name, dates of attendance and degrees, and/or certificates earned as directory information.

Selecting YES will be considered a FERPA release for your emergency contact.

Ethnicity

Race - You may select more than one category.

Citizenship Status

Please note: If you are a citizen of the United States, please select the United States of America. If you are a non-US citizen holding a Permanent Resident card (a Resident Alien), please select Permanent Resident. If you are any other non-US citizen (a Non-Resident Alien or Foreign) select the appropriate option that reflects you.

Country of Citizenship

Type of VISA (if you are a non-U.S. citizen

Calendar year and term you plan to start Cecil College

Degree or Certificate of Study

Are you a first generation college student?

Applicant Type

Cecil County High School Attended

Other MD High School Attended

If High School is not listed above, please enter full name of high school.

Enter High School city and state

High school or GED graduation (or anticipated) date - Use the 15th if you do not know the date of your graduation.

What is your immediate reason for attending Cecil College?

What are your interests? (check all that apply)

Are you a current full-time Cecil College employee? 

By applying to Cecil College, I accept and agree to abide by the policies and regulations as presently in effect (Ex: Convicted Felons and Registered Sex Offenders Policy and Drug Use and Alcohol Prevention Policy) and/or hereafter enacted. In addition, by applying to Cecil College I agree to receive solicited communications from Cecil College regarding campus events, registration dates, scholarship info, and other messages related to the College. For the current listing please visit our Catalog and Policies and Procedures. I also agree that Cecil has permission to use any College-sponsored photographs in which my likeness appears.

I certify that the information on this application form is accurate and complete and that it is my responsibility to notify the College of any changes.