STI APPLICATION FOR ADMISSION

Non-refundable application fee of $20.00 will apply

Southeastern Technical Institute hereby provides notice that it does not discriminate in admission or employment in any of its educational programs or activities on the basis of race, color, sex, religion, national origin, sexual orientation, or disability. Southeastern Technical Institute has a published admission policy that is available to all applicants as part of the admission process. The policy gives the admission criteria, as well as a description of the entire admission process. This application form must be completed and submitted to the Southeastern Technical Institute. In addition to this application form, other criteria for admission include, high school transcripts/GED, college transcripts, completed TABE Entrance exam and a scheduled interview with the designated program director.

Program of Choice:

Practical Nurse Program has a separate application.

First Name:

Last Name:

Street:

Unit:

City/State:

Postal Code:

Telephone:

Cellular Phone:

Social Security#:

Email Address:

Emergency Contact Name:

Emergency Contact Phone:

Name of Employer:

Work Phone:

High school Attended:

Date of Graduation:

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City/State:

Last Grade Completed:

GED:

Date of GED:

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College Attended:

Date of Graduation:

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Certifications/Degrees:

Military Service:

Are you applying for Financial Aid?:

VOLUNTARY EQUAL EDUCATIONAL OPPORTUNITY INFORMATION

The following information is for Affirmative Action purposes only. It does not affect any Admission decisions.

Gender:

Male
Female

Marital Status:

Married / Domestic Parnter
Single / Divorced
Children in your custody

Date of Birth:

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Place of Birth:

Do you have a disability that requires special accommodations?:

Are you a displaced homemaker who supports a family?:

Language spoken at home:

Are you Hispanic or Latino?:

No, not Hispanic or Latino
Yes, Hispanic or Lation: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Race/Ethnicity:

Are you a (check One):

Please Explain:

Do you currently have an educational VISA?:

What is your current VISA:

Country of citizenship:

Please Note: Final acceptance is contingent upon receipt of your official High School transcript or GED scores. Transcripts can be obtained from your High School Guidance Department. Any other institutions of higher learning that you have attended should also send you transcript, contact their admissions office. Forward all transcripts to the Southeastern Technical Institute, 250 Foundry Street, South Easton, MA 02375.

Credit Transfer: Some applicants may transfer college credits in Psychology, Computer Classes, Human Growth & Development, Microbiology, Anatomy & Physiology if you have received a "C" or better within the past (5) years from an accredited college. An official college transcript detailing any and all courses taken must be submitted to the instructor for review to determine previous credit or transfer approval.

How did you hear about our school?:

Student's Name:

Date:

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