First Name                                                                                  Middle Name                                                            Last Name

                          

Preferred Name

Mailing Address                                                                                        City                                                       State      

       

 County                        Zip Code

   

COMMUNICATIONS

Telephone
Mobile Phone
 

DEMOGRAPHICS

Social Security Number
Drivers License

DEPENDENCY


ABOUT MY EDUCATION


LAST COLLEGE

 

LAST HIGH SCHOOL

 
ACT
 

Guidance Counselor

Awards

Extracurricular Activities you have been involved in.


ABOUT MY PLANS AT CRC

I plan to take on-campus classes  

I plan to take on-line classes  

Participate in Student Led Spiritual Activities  

I am interested in playing these sports at CRC

Women's Basketball
Women's Cross Country
Women's Softball
Women's Volleyball
Men's Baseball
Men's Basketball
Men's Cross Country
Men's Golf
   
Housing at CRC

ABOUT MY FAITH


ABOUT MY FAMILY (For Financial Aid Purposes)

   
     
     
       
   
 
What newspaper does your family use? 

LEGAL ISSUES

WAIVER OF RIGHT TO ACCESS TO CONFIDENTIAL INFORMATION

NOTE: PLEASE READ BEFORE PROCEEDING

Realizing the need for Crowley’s Ridge College to obtain an objective opinion as to my qualifications, I hereby waive my right to access any confidential recommendations made for the purpose of determining my fitness for admission to this institution. I also authorize the release of any relevant information in regard to this application for admission. I further certify that I have disclosed all relevant information in regard to this application for admission.

AGREEMENT

Please type
"I agree" or "I do not agree"
waive my right of access in the box above

I certify that the preceding statements and information are correct and complete. If accepted for enrollment, I pledge to abide by the policies of Crowley's Ridge College.


Full Name

Date