MCC Admissions - Application

APPLICATION FOR ADMISSION
Please fill out this form completely. All items marked with an (*) are required.
This application is for US citizens only, International Students complete application here.

*The campus/program that I am applying for (please choose one) is:
Traditional, on-campus LEAD, Adult Degree-completion Distance (online)

*When do you expect to enroll at MCC? Year:

*I will be a: Full-time, Part-time, or Returning student

*Intended Degree: Minor:

Personal Information

*Last 4 digits of your Social Security Number (for identity verification): (numbers only)

*First Name: *Ml: *Last Name:
(please enter names exactly as they appear on official documents)

Preferred Name (if different from first name):

*Birth date: (mm/dd/yyyy) Gender: M F

*Permanent Home Address:

*City: *State: *Zip:

*Home Phone: (123-456-7890) Cell Phone:

*E-mail Address: IM Address:

Emergency Contact Name:

Emergency Contact Phone:

Marital Status: Military Status: Work Phone:

Transcript Information
(all students must submit transcripts from ALL colleges and post-secondary institutions attended)

Institution 1 Name:

Address: City: State: Zip:

Dates attended: Hours Completed:

Institution 2 Name:

Address: City: State: Zip:

Dates attended: Hours Completed:

Institution 3 Name:

Address: City: State: Zip:

Dates attended: Hours Completed:

Please list any additional Institutions you have attended:

*Have you been dismissed from any school or college, or placed on probation?
Yes No If yes, please explain in the text box below:

*Have you ever been denied admission to any college or university? Yes No
If yes, please explain in the text box below:

*Have you ever been convicted of a felony? Yes No
If yes, please explain in the text box below:

ACTIVITES (List any church, school, or extracurricular activities you have participated in):

PERSONAL REFERENCES
(Please send in two reference forms from a minister, teacher, counselor, friend, or employer)

*Reference 1 Name: *Phone: (123-456-7890)

*Address: *City: *State: *Zip:

*Reference 2 Name: *Phone: (123-456-7890)

*Address: *City: *State: *Zip:

ESSAYS

*Write a brief statement of why you are applying to Manhattan Christian College.

*Briefly describe your Christian faith and personal relationship with Jesus Christ.

*What does it mean to you to be a Christian leader?

CHURCH INFORMATION

*Name of the church you are currently attending:

*Address: *City: *State: *Zip:

*Minister's Name:

*How long have you attended this church?

*When did you become a Christian (year or age)?

GUARDIAN AND HIGH SCHOOL INFORMATION (Full-time, traditional program students only)

Parent/Guardian's Name: Phone: (123-456-7890)

Address: City: State: Zip:

I currently live with: If Other, specify:

HIGH SCHOOL currently attending or graduated from:

High School City: St: Date of HS Graduation: (mm/yyyy)

Entrance Testing: ACT taken on: (mm/yyyy) SAT taken on (mm/yyyy)

SIGNATURE and SUBMISSION

By typing my legal name below I certify that the above information is
complete and accurate and carries the weight of my official signature.
I understand that inaccurate or omitted information may later be grounds
for dismissal from Manhattan Christian College.
*Signature:

Upon submission of this form you will be redirected to a secure site to
make payment for the $25.00, non-refundable application processing fee. Your application will not be processed until all reference forms,
transcripts, and payment are received by the Admissions Office.