New Online Application

Under Implementation

Online Application

Welcome

Campus

Program

Program Start Date

How did you hear about us?

Other

Contact Information

First Name

Middle Name

Last Name

Primary Language Spoken

Permanent Address

Country

Street

Street 2

City

State/Province

Zip/Postcode

Home Phone

Cell Phone

If Mailing Address is different from Permanent Address

Mailing Address

Country

Street

Street 2

City

State/Province

Zip/Postcode

Emergency Info

In case of an EMERGENCY, I authorize Manhattan School of computer Technology to notify the following individuals:

Primary Contact Relationship:

Relative

Friend

Primary Contact Name:

Primary Contact Phone Number:

Primary Contact Email:

Alternative Contact:

Relative

Friend

Alternative Contact Name:

Alternative Contact Phone:

Alternative Contact Email:

Personal Information

Residency Status

Nationality

Social Security No

Birth Date

Marital Status

Gender

Are you Hispanic or Latino?

Yes No Not Selected

Ethnicity

Are you intending on applying for Financial Aid?

Yes No Not Selected

English Language Self Assessment

To be completed by non-native English speakers.

How long have you been speaking English?

How is your reading and understanding of daily news?

How is your understanding of radio/TV/what is said to you?

How is your English speaking skills?

How is your English writing skills?

Education

Highest Level of Education

Enter N/A, If you did not complete High School / GED

High School Attended

High School Full Address

HS Graduation Date

General Equivalency Diploma (GED) issuing State

General Equivalency Diploma Date

Documents (Optional at this time)

ID/Passport

High School Diploma/GED

Acknowledgements

I certify that the information I have provided is accurate and complete to the best of my knowledge.

I certify

Please fill out required field: I certify that the information I have provided is accurate and complete to the best of my knowledge.

I accept that I must submit my original educational documents (where applicable) to be reviewed and copied for application consideration.

I accept

Please fill out required field: I accept that I must submit my original educational documents (where applicable) to be reviewed and copied for application consideration.

I understand if my conduct during the enrollment process is grounds for suspension or dismissal for an enrolled student, my application will be rejected.

I understand

Please fill out required field: I understand if my conduct during the enrollment process is grounds for suspension or dismissal for an enrolled student, my application will be rejected.

Type your full name

Signature

Today's Date