COUNTY COMMUNITY

COLLEGE

APPLICATION FOR ADMISSION

Central Admissions 533 College Road Selden, New York 11784 (631) 451-4000 Ammerman Campus Admissions Office 533 College Road Selden, New York 11784 (631) 451-4022 Eastern Campus Admissions Office 121 Speonk-Riverhead Road Riverhead, New York 11901 (631) 548-2512 Michael J. Grant Campus Admissions Office Crooked Hill Road Brentwood, New York 11717 (631) 851-6718 [Link]
Suffolk County Community College promotes intellectual discovery, physical development, social and ethical awareness, and economic opportunities for all through an education that transforms lives, builds communities, and improves society.

2012

DIRECTIONS FOR ADMISSIONS APPLICATION

1. Complete all sections of the application as indicated; be sure to sign and date the application. Complete the Application Fee Processing Form. For current high school students applying to the College, take the application fee processing form, along with your completed application to your high school guidance office to be mailed together with your transcript to the Central Admissions Office, Suffolk County Community College, 533 College Road, Selden, NY 11784. For all other applicants, mail the completed application, and the Application Fee Processing Form to the guidance office of the high school from which you graduated. All applicants should include a check or money order for the $40.00 application fee payable to Suffolk County Community College. DO NOT SEND CASH. 2. If you have received a high school equivalency diploma (i.e., GED), attach a copy of the diploma and scores with your completed application and return to the Central Admissions Office, Suffolk County Community College, 533 College Road, Selden, NY 11784 with the Application Fee Processing Form and a check or money order for the $40.00 application fee payable to Suffolk County Community College. DO NOT SEND CASH. 3. If you have college credits you wish to transfer, request official transcripts to be sent from the college(s) directly to the Transfer Credit Evaluation Office, The Annex, 533 College Road, Selden, NY 11784. For more information visit us at [Link]. Notes: 1. Your application will not be processed until SCCC receives your high school transcript or GED. 2. Please review the online college catalog for special admissions criteria and filing deadlines for certain restricted programs.

SUPPLEMENTAL INFORMATION
JOINT ADMISSIONS If you are interested in transferring to a four-year college upon graduation from Suffolk, then Joint Admissions may be of interest to you. Upon completion of your associate degree, you can transfer to one of the participating colleges providing you meet the requirements of the joint admissions agreement. This guaranteed admission to the four-year college will be honored for a two-year period following graduation from Suffolk, providing you do not matriculate at another institution. Note that you are under no obligation to attend the four-year college should your plans change for any reason. To apply for joint admissions, refer to the list of participating colleges on [Link]/Students/[Link]. You should also consult the catalogs from both Suffolk and the four-year college prior to admission. During your first semester at Suffolk, it is recommended that you speak with a counselor regarding your joint admissions plans. Suffolk may share enrolled student information with colleges with which it has joint admissions or articulation agreements. EDUCATIONAL OPPORTUNITY PROGRAM (EOP) The Educational Opportunity Program (EOP) is designed to provide academic support to students enrolled full-time in a curriculum at the college. Students admitted to the program have the academic potential to attain a college degree but may need additional academic support and counseling throughout their time at the college to persist to graduation. Eligibility The program is offered to full-time students who are New York State residents for twelve months prior to attending college. EOP accepts students who qualify academically and financially based on the following guidelines: a. New York State resident; b. recipient of a high school diploma, GED or its equivalent; c. full-time registration; d. 79 or less high school average in major subjects, or placement in one or more developmental courses; e. non-high school graduate who is admitted to SCCC through the Ability to Benefit (ATB) program; f. meet NYS legislated income HONORS PROGRAM The Honors Program is a college-wide interdisciplinary program for academically talented and highly motivated students. It is grounded in the traditions of the liberal arts and stresses the connections among various disciplines and the tools of artistic, scientific, and intellectual creativity. The Honors Program combines small classes, gifted faculty, enthusiastic students, rigorous course work, and various activities to create an environment that nurtures intellectual growth. Honors classes are offered during the day and evening and are available to both part-time and full-time students on all three campuses. For requirements, visit [Link]/Students/[Link].

The Personal Privacy Protection Law requires this notice to be provided when collecting personal information from individuals. The information on this Admissions Application will be used by SCCC to evaluate your request for admission. Failure to provide the requested information could prevent your application from being processed. The authority to request this information is found in Section 355 (2) (i) of the Education Law. This application information will be maintained in the College Records Office. The official responsible for the maintenance of this information is the College Registrar, Suffolk County Community College, 533 College Road, Selden, NY 11784. It is the policy of Suffolk County Community College not to discriminate in admissions on the basis of race, color, religion, sex, age, marital status, sexual orientation, national origin or handicap, except as such conditions may constitute bona fide occupational or assignment qualifications in Nursing and Health Careers courses and the departmental health requirements. All campus crime statistics are available on the College website at [Link]/safety.

SUFFOLK COUNTY COMMUNITY COLLEGE

APPLICATION FOR ADMISSION
A. BACKGROUND INFORMATION: 1. Social Security number*: ___ ___ ___ - ___ ___ - ___ ___ ___ ___ 2. Name: ________________________________________________________________________________________________________ (Last) (First) (MI) 3. Other name(s) on your academic credentials: __________________________________________________________________________ 4. Mailing address: _________________________________________________________________________________________________ (City) (State) (Zip Code) (Number and Street or P.O. Box #) Legal address (if different from above) _______________________________________________________________________________ (Number and Street) (City) (State) (Zip Code) 5. Have you previously submitted an application or attended Suffolk? 6. Telephone number:

Please Use Black or Blue Ink

q Yes q No

If yes, SCCC ID# __________________________

Home ______________________________________ Mobile ______________________________________ Year _________

Email ____________ ____________________________________________________________________________________________ 7. Date of birth: Month _________ Day _________

q Female 9a. Are you Hispanic/Latino? q Yes q No

8. Gender: 9b. If Hispanic/Latino, is your background (select one):

q Male

q Central American

q Dominican

q Mexican

q Puerto Rican

q South American

q Other Hispanic/Latino

9c. All applicants, please indicate your race (select one or more):

q American Indian or Alaska Native q Asian q Black or African American q Native Hawaiian/other Pacific Islander q White 10. Veteran of U.S. Armed Forces: q Yes q No NOTE: If yes, please attach a copy of your DD 214 for evaluation of possible transfer credit.
All applicants (freshman and transfer students) MUST answer questions 11 and 12. 11. Have you ever been convicted of a felony? (required)

q Yes q No q Yes q No

12. Have you ever been suspended, dismissed or expelled from a college or university for disciplinary reasons? (required) B. RESIDENCY/CITIZENSHIP INFORMATION: 13. Resident of New York State for prior 12 months: 14. Resident of Suffolk County for prior 6 months: NOTE: If you are a New York State resident but have not resided in Suffolk County for six months, contact your County Clerks Office for an Affidavit of Residence Form.

q Yes q Yes

q No (specify state) _____________________________(required) q No (specify county) ___________________________(required)

15. Country of citizenship: q United States q Other (Specify and complete box below) ____________________________(required) If you are a U.S. citizen, continue to section C, College Plans.

NON-U.S. CITIZENS

If you are not a citizen of the United States, answer questions 16-17.
16. Are you a legal permanent resident of the United States? If No list visa you presently hold:

q Yes

q No

If Yes please submit a copy of your permanent residency card with this application and continue to Section C College Plans.

q F-1 q J-1 q H 1-4 Other visa type: ______________________

Expiration date: ____________________ (Attach a copy of your I-94 Form or other official document which verifies your last visa status.) 17. Do you wish to apply for a student (F-1) visa?

q Yes q No If yes, you and your Suffolk County sponsor can review the International Admissions page at
[Link]/Prospects/[Link] for more information. NOTE: If you have an F-1 visa from another school, you must go through the international student admissions process at Suffolk County Community College. Students who are granted a student (F-1) visa must enroll and attend full-time (12 or more credits) for fall and spring semesters. C. COLLEGE PLANS: Refer to the attached list of programs of study; take note of any special admission requirements and campus site. 18. Semester and year applying for: 19. Campus preference:

q January 20 _____ (Spring) (or) q September 20 _____ (Fall) q Ammerman (Selden) q Eastern (Riverhead) q Michael J. Grant (Brentwood)
Code _____________________________

20. Program Choice: ________________________________________________________

(For nursing applicants only) Second Choice: ___________________________________ Code _____________________________

*Your Social Security Number is used to coordinate the collection of information for all your student records. Authority to collect the Social Security Number is granted under Section 355 of the New York Education Law.

SUFFOLK COUNTY COMMUNITY COLLEGE PROGRAMS OF STUDY

DEGREE CAMPUS CODE DEGREE CAMPUS CODE AA Liberal Arts & Sciences-Education (Child Study): AAS Accounting (Career Option) A E G ACCT-AAS Jointly registered with St. Josephs College A E G EDCS-AA AS Accounting (Transfer Option) A E G ACCT-AS AA Liberal Arts & Sciences-Secondary Education: Cert Accounting A E G ACCT-CERT Jointly registered with St. Josephs College A E G AAS American Sign Language: Biology option (leading to a B.A.) A E G AEBA-AA Interpreter for the Deaf Sequence l A ASL-INT-AAS Biology option (leading to a B.S.) A E G AEBE-AA American Sign Language Studies Sequence A ASL-STDY-AAS English option (leading to a B.A.) A E G AEEE-AA AAS Automotive Service Specialist: . History (Social Science leading to a B.A.) A E G AEHE AA General Motors Option l A AUTO-AAS Mathematics option (leading to a B.A.) A E G AEMA-AA Generic Option l A AUTO-AAS Mathematics option (leading to a B.S.) A E G AEME-AA Honda Option l A AUTO-AAS AA Liberal Arts & Sciences-General Studies A E G LAGS-AA AAS Business Administration (Online Option) A E G BUAO-AAS AA Liberal Arts & Sciences-Humanities: AAS Business Administration (Career Option) A E G BUAD-AAS English Option A LAEG-AA AS Business Administration (Transfer Option) A E G BUAS-AS Cinema Studies Option A LACS-AA Cert Business: Business Management A E G BUMG-CERT Philosophy Option A LAPL-AA Cert Business: Information Processing A G BUIP-CERT Communications Option A LACM-AA AAS Business: Marketing G BUMK-AAS Foreign Language Option A LAFL-AA AAS Business: Office Management A E G BUOM-AAS Creative Writing Option A LACW-AA AAS Business: Retail Business Management A BURM-AAS AA Liberal Arts & Sciences-International Studies: A E G LAIS-AA Cert Business: Retail Management A BURM-CERT AA Liberal Arts & Sciences-Mathematics A LAMA-AA AAS Chemical Dependency Counseling G CHDPD-AAS AS Liberal Arts & Sciences: Biology Option A E G LABI-AS AA Communications and Media Arts: Journalism A COMA-AA Environmental Science/Forestry Option A E G LAFR-AS AA Communications Studies A E G COST-AA Chemistry Option A LASC-AS AAS Computer Art l E COAR-AAS Earth and Space Science/Astronomy Option A LAAS-AS AS Computer Science A COSC-AS Physics Option A LAPH-AS AAS Construction Technology-Architectural Technology A CTAT-AAS Earth & Space Science/Geology Option A LAGE-AS AS Criminal Justice A E G CRJU-AS Earth & Space Science/Meteorology Option A LAME-AS Cert Criminal Justice: Police Administration G CJPA-CERT AA Liberal Arts & Sciences-Social Sciences: (police officer recruits only) Psychology Option A G LASP-AA AAS Culinary Arts/Restaurant Management E CURM-AAS Sociology/Anthropology Option A G LASA-AA AAS Culinary Arts/Baking and Pastry Arts E CUBP-AAS History Option A G LASH-AA Cert Culinary Arts: Restaurant Management E CURM-CERT Political Science Option A G LASS-AA Cert Culinary Arts: Baking &Pastry Arts E CUBP-CERT AA Liberal Arts & Sciences-Womens Studies A LAWS-AA AAS Dietetic Technician (Day) l E DIET-AAS AAS Manufacturing Technology l G MFTY-AAS Cert Drafting-(CAD) A DRFT-CERT AS Music A MUSC-AS AAS Early Childhood n A E G EACH-AAS AAS Nursing (Day) (Fall Start) l u s A NURS1-AAS AS Early Childhood n A E G ECAS-AS AAS Nursing from LPN (Day) (Spring Start) u n A NURS2-AAS AAS Electrical Technology Electronics A ELTC-AAS AAS Nursing (Day) (Fall Start) l u s G NURS4-AAS AS Engineering Science A ENSC-AS AAS Nursing from LPN Day (Fall Start) l u s G NURS5-AAS AAS Fire Protection Technology A FRPT-AAS AAS Nursing (Evening) (Fall Start) l u s A NURS3-AAS Cert Fire Investigation A FRPT-CERT AAS Nursing (Evening) (Spring Start) u n G NURS6-AAS AS Fitness Specialist A FTSP-AS , AAS Occupational Therapy Assistant (Day) l s G OCTA-AAS AAS Graphic Design l E GRDS-AAS AAS Paralegal Studies A G PALG-AAS AAS Health Information Technology/ Cert Paralegal Studies A G PALG-CERT Medical Records (Evening) l G HEIT-AAS AAS Paramedic A PARM-AAS AAS Heating, Ventilation, Air Conditioning & Refrigeration G HVAC-AAS AAS Photographic Imaging l E G PHOT-AAS CERT Heating, Ventilation, Air Conditioning & Refrigeration G HVAC-CERT Cert Practical Nursing (LPN) (Day) u E NUPN-CERT AAS Hotel and Resort Management E HRMN-AAS AAS Physical Therapist Assistant l u s A PHTA-AAS CERT Hotel and Resort Management E HRMN-CERT AAS Radio & Television Production l A RATV-AAS AS Human Services (Preparation for Social Work) A HUSR-AS AAS Telecommunications Technology: AAS Information Technology: Verizon option (Verizon employees only) A TETE-AAS Network design and Administration A E G ITND-AAS AS Theatre Arts: Computer Information Systems A E G ITIS-AAS General Theatre Option A THGT-AS Internet/Web Development A E G ITIW-AAS Acting Option A THAC-AS Cert Information Technology: Technical Theatre Option A THTT-AS Network Design and Administration A E G ITND-CERT AAS Veterinary Science Technology (Day) l G VETSD-AAS Computer Information Systems A E G ITIS-CERT Veterinary Science Technology (Evening) l G VETSE-AAS Internet/Web Development A E G ITIW-CERT (Offered in even-numbered years) AAS Interior Design l E INDA-AAS AS Visual Arts A G VART-AS

l Curriculum begins in September only. u Suffolk County residents are given preference. s Preference will be given to applications received by January 1. n Preference will be given to applications received by June 1. Campus Codes: A=Ammerman Campus at Selden E=Eastern Campus at Riverhead G=Michael J. Grant Campus at Brentwood

ENROLLMENT Checklist
Send your completed application, official high school and college transcripts and application fee to Central Admissions. You will receive your decision letter after your application has been processed. If you are transferring college credits, you must send an official copy of all college transcripts to the Transfer Credit Office, Suffolk County Community College, The Annex, 533 College Road, Selden NY 11784. Please be sure to bring unofficial transcripts of college courses taken elsewhere to your advising appointment.

q 1. APPLY FOR FINANCIAL AID:

Online filing is available at [Link]. You can obtain further information at [Link]/FinancialAid

q 2. SUBMIT YOUR IMMUNIZATION RECORDS:

If your immunization records were not submitted with your application, you will need to provide documentation for two Measles, Mumps, and Rubella (MMR) immunizations. In addition, you will need to complete the Meningitis form.

q 3. REGISTER FOR CLASSES:

After meeting with the Academic Advisor and selecting your classes, you will proceed to the Registrars Office to register for your chosen classes.

q 4. PAY YOUR TUITION:

Tuition and fees must be paid no later than the date indicated on your schedule/bill which you will receive after registering. If the bill is not paid by the payment due date, you will lose your schedule of classes. If you have filed for financial aid, and expect to receive federal, state or scholarship funds in full or partial payment of your tuition and fees, please check that they are in place before the payment due date.

q 5. OBTAIN A STUDENT ID CARD:

After you have paid your tuition and fees, you will need to obtain a student ID card. The card must be carried with you at all times when you are on campus. Visit the public safety section of the college website for information on obtaining your student I.D. card.

q 6. ATTEND STUDENT ORIENTATION:

Students and their parents are invited to new student orientation shortly before the beginning of the College semester. All students are encouraged to attend and become involved in the life of the campus through campus clubs and activities.

SUFFOLK COUNTY COMMUNITY COLLEGE

APPLICATION FEE PROCESSING FORM - Please Enclose Application Fee ($40.00) Be sure to include applicants name and social security number on check or money order.

APPLICANTS NAME - PLEASE PRINT

SOCIAL SECURITY NUMBER*

PRINT CURRENT ADDRESS

STATE

ZIP
4

*Your Social Security Number is used to coordinate the collection of information for all your student records. Authority to collect the Social Security Number is granted under Section 355 of the New York Education Law.

21. Are you applying for Joint Admissions? If yes, indicate your college choice: ______________________________________________ NOTE: Please refer to the list of specific programs at [Link]/Students/[Link]. 22. I am interested in the following areas: 23. 24.

q Intercollegiate Athletics q Educational Opportunity Program (EOP) q Financial Aid q Student Leadership q On-Campus Childcare q Honors Program

q Check here if you would like information regarding services for students with a disability. q Check here if your native language is not English and you are interested in the English as a Second Language program.
Choose the one response which best describes your intentions.

D. EDUCATIONAL GOAL:

q 1. Uncertain/no definite purpose in mind q 2. To take a few courses for job-related advancement q 3. To take a few courses for self-improvement q 4. To take courses and transfer to a non-State University of New York (SUNY) school prior to completing a degree q 4a. To take courses and transfer to a State University of New York (SUNY) school prior to completing a degree q 5. To obtain or maintain a license or certification (i.e., without completing a degree) q 6. To complete a one-year certificate program q 7. To complete an associate (two-year) degree for entry into the workforce q 8. To complete an associate (two-year) degree and transfer to a non-State University of New York (SUNY) school
bachelors (four-year) degree program

q 8a. To complete an associate (two-year) degree and transfer to a State University of New York (SUNY) school
bachelors (four-year) degree program

q 9. Non-applicable

E. PREVIOUS EDUCATION: 25. Name of HighSchool: _____________________________________________________________________________________________ Street: __________________________________________________________________________________________________________ City: _______________________________________________________________ State: ___________________ Zip: _______________ Graduation Date: Mo. ______ Yr. ________ (or) Withdrawal Date: Mo. ______ Yr. ________ (Complete Item 27) If you received an Individualized Education Program Diploma, please contact the campus Admissions Office for information on applying for the Ability to Benefit program, which leads to a High School Equivalency Diploma.

26. If you withdrew from high school, do you have a General Equivalency Diploma (GED)?

q Yes Mo. _____ Yr. _____ (Attach a copy of diploma and scores and return with application.) q No
State _______ _______ _______ Dates From _____ _____ _____ Attended To ______ ______ ______ Degree Awarded ______________ ______________ ______________

27. Colleges/universities attended (most recent first). Name 28.

___________________________________________________________ ___________________________________________________________ ___________________________________________________________

NOTE: It is your responsibility to send college transcripts, or CLEP, or ADVANCEDPLACEMENT score reports to the Transfer Credit Evaluation Office, c/o Central Admissions, 533 College Rd, Selden NY 11784.

q I declare that all information on this application is true to the best of my knowledge. q I am enclosing the $40 application fee which I understand is not refundable.
__________________________________________________________________ _____ (Signature - required)* _________________________________ (Date)

* By virtue of this signature, I authorize the release of my final official transcript(s) by my previous institution(s) in the event that I decide to enroll at Suffolk as a matriculating student.