Athens Technical College
Application for Admission

Dual Enrollment

A COMPLETE APPLICATION CONSISTS OF:

Application for High School Admission with ALL items answered
Official transcripts from high school
Placement test scores (ACCUPLACER,ASSET, SAT, ACT, or COMPASS) less than 5 years old
Completed and Signed Recommendation and Permission form (This form will be generated and emailed to you upon completion of this application)
Home School Students must also complete the Declaration of Intent

Personal Information

Date:

^*First Name:

Middle Initial:

^*Last Name:

^*Date of Birth:
^*Social Security Number:

First Three Numbers of Social Security Number

Second Two Numbers of Social Security Number

Last Four Numbers of Social Security Number

^*Street Address (include box or apartment number):

^*City:

^*State:

^*Postal Code:

^*County of Residence:

^*Daytime Phone:

^*Emergency Contact Name:

^*Secondary Phone/Contact Phone:

^*Email Address:

Residency Information - Part A

^*Are you a US Citizen (If YES Proceed to residency PART B)
Permanent Resident
International Student

Residency Information Part B

^*Check ONLY the section that describes you. The following information will be used to determine tuition rates and financial aid eligibility. Failure to provide accurate information may impact tuition I am UNDER 24 years of age, my parent(s) or legal guardian(s) have claimed me on their most recent federal/state tax return, and they HAVE resided in the state of GEORGIA for the last 12 consecutive months.
I am UNDER 24 years of age, my parent(s) or legal guardian(s) have claimed me on their most recent federal/state tax return, and they HAVE NOT resided in the state of GEORGIA for the last 12 consecutive months.

Application and Program Information

^*Entry Term
^*Year:
^*Campus you plan to attend:

^{Have you ever been accepted or enrolled at ATC?} Yes
No

^*What is your long-term educational goal?
To complete a certificate, diploma or degree from Athens Technical College
To receive credits from Athens Technical College to transfer to another college or university
To take classes for enrichment purposes
Not sure / Other
If you selected Other Educational goal, can you elaborate?

High School and Testing Information

^*Please select one of the following: Currently attending high school (public or private)
Currently attending high school (home schooled)

High School:
City and State:
Grade Currently Enrolled In:
^*Year of Anticipated Graduation:

^*Indicate which placement test you have taken within the last 5 years:
ACCUPLACER
ACT
ASSET
COMPASS
SAT
I have not tested in the past 5 years

Final Review and Submission of Application

You are about to submit your application electronically to Athens Technical College.

By submitting this application, I give Athens Technical College permission to contact me at the telephone numbers I have provided via any means, including text and voice messages.

*I certify that the foregoing information contained in this application is true and correct.
I understand that the misrepresentation or omission of information will be sufficient cause for rejection
or dismissal. Yes
No

Type your name in the field below as you would Sign an official document

^* Signature:

Case sensitive

Please enter text in image:

* Indicates Response Required

As set forth in its student catalog, Athens Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political affiliation or belief, genetic information, veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). The following individuals have been designated to coordinate the college's implementation of nondiscrimination policies: Keli Fewox, Director of Student Support, Section 504 and the Americans with Disabilities Act (ADA) Coordinator, Office K-614A, 706/355- 5081, kfewox@athenstech.edu; Becky Burton, Human Resources , Title VI, Title VII, Title IX Coordinator (Employees), Office K-514, bburton@athenstech.edu, 706/583-2818; and Jennifer Benson,Vice President of Student Affairs, Title IX (Students) Office H-774, 706/355-5029; jbenson@athenstech.edu ; 800 U.S. Highway 29 North, Athens, GA 30601.
* Section 504 and Americans with Disabilities Act (ADA): Director of Student Support Services and Career Development, Room 731, (706) 355-5081

ATTENTION!

Please read and acknowledge the following:

To complete your admissions application, you will also need to submit the following documents to admissions:

Official High School Transcript
Recommendation and Permission Form. This form will be emailed to the address you provide on this application
Official Test Scores from either : SAT,ACT,ACCUPLACER,COMPASS,or ASSET that are less than 5 years old
Home School Students must also submit the Declaration of Intent

If any of the following are omitted, your application may be delayed.

Please click the button below to acknowledge that you understand the abover requirements for admission.