Please use your full legal name (no nicknames):

* First Name

Middle

* Last Name

Suffix

[e.g., Jr., III]

Preferred Name

* Social Security Number

- - Why is my SSN required?

* Date of Birth

Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999

Marital Status

Please select Single Married

NOTE: Your marital status is a required field ONLY if you plan to apply for financial aid.

NOTE: Fill out this area ONLY if you used a different name in your academic records.

Other First Name

Other Middle

Other Last Name

NOTE: This information is gathered for reporting, report keeping and student assistance. Responses to these questions are voluntary and have nothing to do with the admission decision.

Gender

Please select Male Female

Ethnicity

Please select Black Non-Hispanic Asian or Pacific Islander White Non-Hispanic American Indian or Alaska Native Hispanic Other

* State of Residency

* Residency Began

Month January February March April May June July August September October November December Year 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Previous State of Residency

* Street / P.O Box

Address (cont'd)

* City

* County

* State

* Zip

* Home Phone

( ) - -

Cell Phone

( ) - -

E-mail Address

NOTE: You will NOT receive an e-mail confirmation if you do not enter an e-mail address

Did your parent/guardian graduate from Northwest or any other Wyoming college?

Yes, from

Please select NO Wyoming Community College Casper College Central Wyoming College Laramie County Community College Northwest College Sheridan College Western Wyoming College Eastern Wyoming College year 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

NOTE: Nonresident students whose parent/guardian graduated from a Wyoming community college (transcripts from the college are required) qualify for resident tuition rates.

If your parent/guardian attended NWC, what name did they use?

Have either of your parents graduated from a 4-year institution? Yes No

NOTE: You are ONLY required to answer if you are under the age of 18.

* Full Name

This person is my

Parent Guardian Spouse

* Street / P.O Box

Address (cont'd)

* City

* Country

* State

* Zip

* Home Phone

( ) - -

Cell Phone

( ) - -

DEGREE SEEKING FULL-TIME and PART-TIME STUDENTS
Before admission can be determined you:
•Must submit official copies of high school transcripts OR
•Submit a GED score report

ALL STUDENTS
Born after 1956 must submit proof of MMR immunization before admission can be finalized.

All students are encouraged to submit ACT or SAT scores or take COMPASS
Placements tests.

TRANSFER STUDENTS
Official transcripts from all other institutions attended must be on file before you can be considered for admission, whether or not credit was earned.

Transfer students with fewer than 15 semester hours of transfer credit must also submit an official high school transcript or take COMPASS Placement tests.

* High School Attended

* City

* State

* Date of Graduation

Month January February March April May June July August September October November December Year 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2009 2010

OR

* Date Completed

Month January February March April May June July August September October November December Year 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2009 2010 Homeschooling or GED

* Semester you plan to enroll at NWC: Fall  Spring   Year 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Do you plan to attend summer session? Yes  No

* Intended student status:   Please select New freshman, no previous college attendance. I want to take college courses while in high school. Transfer to Northwest from another college. I want to readmit to Northwest College.

NOTE: Students applying for federal financial aid must declare a major.

I am applying for Dual Admissions with:

NOTE: Remember there is an application fee due to the 4-year institution.

NOTE: Freshman students enrolled in 9 or more hours are required to live on campus for two semesters. Freshmen are exempt if they are age 21 and over, married, parents with custody of children, or living with their parents.

* I plan to live

 In a residence hall

 

 In the campus apartments (Some restrictions apply. Please contact the Residence Life / Housing Office for details.)

 

 With parents or guardian

 

 Off campus, personal arrangement

Northwest offers a number of services to enhance your educational experience. Please select from the list below to receive more information:

Students at Northwest enjoy a rich variety of activities and sports. Please select form the list below to receive more information: