989.356.9021

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Application for Admission
 
 
 
Items in bold type are required.
Name
  Last Name First Name Middle Initial Suffix Maiden Name
  (Please provide full legal name-for identification purposes only.)
Address
  Street Address City State/Province Zip Code County
 
Country
Phone      
  Cell Phone Home Phone      
Social Security Number 
(Format: 999999999)
     
Gender  Date of Birth        
Ethnic Hispanic/Latino
       
Race (choose one or more)
Email Address    
Start Term
Program of Study
 
Campus Location
 
Admission Status
 
Citizenship
Language
Marital Status
Residency
Are you or have you ever been a member of the U.S. Military?      
Are you the spouse/dependent of a U.S. Veteran?      
Emergency Contact Person
Emergency Contact Phone Number
Last High School Attended City  State 
Graduated from High School?
Years of High School Attendance Years Attended       to      
Transfer Information: If you have attended another college or university, complete the information below and have all official college transcripts sent directly to the Registrar's Office, Alpena Community College, 665 Johnson Street, Alpena, MI 49707-1495.
College Degree  Years Attended       to      
College  Degree Years Attended       to      
The information on this application is accurate. I understand that providing false information could lead to disciplinary action.

Alpena Community College Institutional Statement of Non-discrimination

For any publication that is related to any activity, service or program that utilizes federal funds:

Alpena Community College policies and practices for admission, employment and activities comply with requirements of Title VII of the Civil Rights Act of 1964, Title IX of the Education Amendment of 1972 as amended, Section 504 of the Rehabilitation Act of 1973 as amended, the Age Discrimination in Employment Act of 1967 (ADEA), the Americans with Disability Act (ADA) of 1990, the ADA Amendments Act of 2010, Title II of the Genetic Information Nondiscrimination Act of 2008. The College does not discriminate on the basis of race, color, religion, national origin, gender, sex, age, or disability. The College practices and policies also comply with the Michigan Persons with Disabilities Civil Rights Act (PDCRA) and the Michigan Elliott-Larson Civil Rights Act (ELCRA) which prohibits discrimination in hiring based on age, height, weight and marital status and familial status in addition to race, color, religion, sex (which includes pregnancy) and national origin. For more information, contact the Title IX, Section 504, the Age Discrimination Act and the Title II coordinator: 
Carolyn Daoust, Title IX Coordinator/Director of Human Resources 
Office: ACC, Room VLH102 
Phone: (989) 358-7211 
Email: daoustc@alpenacc.edu 

Alpena Community College publishes an Annual Security Report and Annual Fire Safety Report to comply with the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act, as amended. In compliance with federal law, the College notifies all prospective students and employees of how to locate this information. The full text of this report can be located on the ACC website at: http://discover.alpenacc.edu/acc_asr.pdf Paper copies of the report can be obtained at Van Lare Hall Room 110 or by calling (989)358-7235.