Email*

First Name*

Last Name*

Phone Number*

Date of birth*

What is your marital status?*

Married

Single

How many children, under the age of 18, are you the primary care provider for?*

Are you a new or continuing student?*

Continuing Student

New Student

Student ID Number

FAFSA Complete*

Yes

No

High School Name

What is your high school graduation year?

What is your current cumulative GPA?*

Current state of residency*

Program of studyPlease SelectAccounting and Financial ServicesAdvanced Manufacturing and Engineering TechnologiesAdvanced Welding Certificate Associate of Arts (General Studies)Associate of Individualized StudyAssociate of ScienceAssociate of Technical StudyAutomotive TechnologyBusiness Management and EntrepreneurshipCanine Assisted ServicesCanine CertificatesCommercial Driver's License (CDL) CertificateConstruction Management: CarpentryCriminal Justice - Law EnforcementCulinary ArtsCulinary Arts: BakingCybersecurity and Network SystemsDental HygieneDriver EducationEarly Childhood Teacher EducationEMT / Paramedic CertificateEnvironmental Science Equine Health and Complementary TherapiesEquine Teaching & TrainingFarrier Science & BusinessFashion Design and Retail MerchandisingFermentation ScienceFilm and Video ProductionFire & Emergency Medical ServicesFirefighter CertificateFish Management and Aquaculture SciencesFitness ManagementForest Management Healthcare InformaticsHeavy Equipment ManagementHeavy Equipment Operator CertificateHospitality & Events ManagementHVACLaboratory Science -Majors in Medical LaboratoryLaboratory Sciences: Medical CannabisLPN to RN Transition ProgramMedical AssistantMusic and Recording IndustryNatural Resources Law Enforcement Ohio Peace Officer Basic CertificateParks and Museum EducationReal Estate CertificateSocial WorkSports Management Timber Harvesting and Tree Care CertificateTower Technician CertificateUndecidedWater and Wastewater ManagementWildlife Resources Management

Submit