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Cleveland State Community College

 

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Information

Prospective Student Information Page

Required - indicates a required field.
Please enter your full legal name. If you have attended CSCC under a different last name in the past (for example, maiden name), please enter that name so that we may search for your records.

Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Permanent Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

E-mail Address:Required
Verify E-mail Address:Required

Date of Birth:Required Month Day Year (YYYY)

Please provide your SSN. This information will be kept secure and will be used solely to determine if we have an existing record for you in our database.

U.S. Social Security Number: (999999999 or 999-99-9999)

Gender: Male Female Not Specified

Anticipated Entry Term
Term of Entry:Required

Home Schooled (check for yes):
OR
High School Code:
High School Name:Required
Address Line 1:
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

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Release: 8.7.2