Inquiry
Name and Contact Information
Legal First Name
Legal Last Name
Suffix
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Sr.
III
II
Email
Street Address
Apartment Number
City
County:
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* Out of State
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Zip/Postal Code
How did you hear about CCTC?
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"I DEFY" Ad or Governor's Letter
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Testing Center Registration
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Education Background
Are you currently a high school student?
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High School Attended:
High School Graduation Year:
Have you attended college?
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Program Information
Anticipated Start Term
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Fall
Spring
Summer
Anticipated Start Year
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2023
2024
2025
2026
2027
Please select one that applies to you:
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Adult
High School
Military
Web Prospect/Inquiries
Transfer
Transient
Anticipated Degree
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Certificate
Diploma
Associate
Dual Enrollment (High School Students Only)
Are you a 2nd year student?
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Anticipated Major
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Accounting Specialist
Automotive Technology
Basic Air Conditioning and Heating
Basic Machining and CNC Fundamentals
Child Care Assistant
Computer Specialist
Cybersecurity
Early Childhood Development
Entrepreneurship/Small Business Management
Environmental Health & Safety
Gerontology
Human Services Certificate
Infant and Toddler Care
Massage Therapy
Mechatronics Fundamentals
Medical Record Coding
Office Management
Pharmacy Technician
Pipe Welding (Advanced)
Supervision and Leadership Foundation
Undecided
Wastewater Operator
Water Operator
Welding
Anticipated Major
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Advanced Air Conditioning and Heating
Advanced CNC Programming
Advanced Mechatronics Technology
Advanced Medical Record Coding
Automotive Diagnostic Technology
Inpatient Medical Coding
Undecided
Anticipated Major
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Medical Assisting
Anticipated Major
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Accounting
Associate in Arts
Associate in Science
Computer Technology
Criminal Justice Technology
Early Care and Education
Engineering Design Technology
Environmental Engineering Technology
Management
Natural Resource Management
Nursing (ADN)
Nursing (LPN to ADN)
Human Services
Surgical Technology
Undecided
Additional Information
Birthdate (mm/dd/yyyy)
Gender
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Female
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Home Phone
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