Personal Information (Section 1 of 5)

Full Legal Name:    
Please enter your full, legal name as it appears on your state or federal identification.

Preferred Name :
 

Phone number:       Cell      Home    Other

Phone number 2:       Cell      Home    Other

Does your phone accept text messages?    Yes     No   

email address:

Your Street address:

Apartment number / additional:   

City:          State:         
 Zip:    If outside of US, enter country: 

Additional address information:

PO BOXES ARE NOT ACCEPTED. Your address is used to verify identity upon enrollment.

Program of Interest (Section 2 of 5)

Level of award interested in:  Please select one Bachlor of Science 2+2 Associate of Applied Science Degree Technical Diploma

Select Program (s) of interest:  Check all that apply.

(Bachelor Only) Business Management in the Global Economy (2+2) Program,
Requires completion of an Associates Degree. If you would like to take both the Associates Degree and the Bachelors Degree please select both options. Your decision now can be changed at a later date.
____________

Business Administration and Information Technology (Associates Degree or Diploma)

  Network Administration and Information Security (Associates Degree or Diploma)

Computer Programming and Systems Design (Associates Degree or Diploma)

Web Development and Internet Technology  (Associates Degree or Diploma)

Criminal Justice (Associates Degree or Diploma)

Health Information Technology (Associates Degree or Diploma)

Not Sure? Check this box: 
 

How do you plan to fund your education? 
 

High School Diploma or GED Information (Section 3 of 5)

Do you have a GED or HS Diploma?    Yes     No     
(This is required for admission to ACOT)

If Yes, what is the name of your school or issuing agency

In what City and State did you complete your High School Diploma or GED 

In what year did your earn your High School Diploma or GED 
 

Previous College Experience (Section 4 or 5)

Have you previously attended another college or university?  Yes     No  

If yes, please tell us the name, city and state of your previous college.     

Graduate?  Yes     No   

Do you have military background?  Yes     No   

If yes, which branch of the military 

If you are a spouse or dependant of an Active Military Member or Veteran check this box: 

Additional Required Questions (Section 5 of 5)

Are you currently employed?    Yes     No   

If yes, how many hours a week do you work on average? 

Do you have regular access to a computer and internet?  Yes     No

Are you able to view a computer screen for at least one hour at a time?  Yes   No

Have you previously attended or applied to ACOT?  Yes     No   

If yes, when was your last attendance or application?  

Please tell us your motivations for seeking higher education and how we can help you with your goals.

Have you spoken to someone at ACOT regarding your educational goals?  Yes     No   

ACOT representative's name:

    How did you hear about ACOT? Please Select One Google yahoo Bing Military.com Other Search Engine Word of Mouth Radio TV Local Event Other An approved school list

If referred by current student, please enter name: