Printed Application for Admission

DO NOT USE THIS FORM TO SUBMIT A CHANGE OF ADDRESS OR CHANGE OF MAJOR TO THE COLLEGE!

To change your address on record with us, go to Web Advisor for Students and select "Change Address" (under User Account after logging in) or contact Admissions at 215-968-8100.

To change your major or name on record with us, you must log in at the online Admissions Forms page or submit a request on paper.

Print this form, sign it, and mail or fax it to:

    Bucks County Community College
    Office of Admissions
    275 Swamp Rd.
    Newtown, PA 18940
    FAX: 215-968-8110

Note: Required fields are indicated with an asterisk (*)

Information About You...

Privacy Policy

The privacy of the information you disclose to us on this application will be handled in accordance with the Notification of Student Rights under the Family Educational Rights and Privacy Act (FERPA) [link opens in new window].

Your Full Name











Demographics

 

 



 

 
Address
   - 
Email:
Your Email Address

Bucks uses the email address you provide to send you personalized and confidential information about you, such as your student number and application status. It is your responsibility to provide us with an email address that is correct, secure and private.


xxx-xxx-xxxx
Citizenship Status
NOTE: If you cannot or do not wish to provide your social security number on this form, note that processing of your financial aid application may be delayed.
 
If you are NOT a US Citizen: *

Immigration Status
-

 

Notes: If you are not a US Citizen, your application will remain incomplete until you forward copies of your immigration documents to the Admissions Office.

Holders of F visas and undocumented students: Contact Multicultural Student Services at 215-968-8107 for information on correct application procedures.

All visa holders are subject to out-of-state tuition rates, due to Commonwealth of Pennsylvania guidelines.

Veteran Status
 
Your Employer
-
Emergency Contact


Education Information...
Your Educational History
 
 If your High School was not specifically listed, enter its city and state here:
 
Current and/or Previous Colleges (most recent first)
NOTE: Bucks does NOT automatically evaluate transcripts for prerequisite waivers and/or transfer credit. By default, transcripts are evaluated only to determine whether you must complete placement testing at Bucks.

For each school below, indicate whether you are having an official transcript sent and whether you wish that transcript evaluated for prerequisite waivers and/or potential transfer credit. Details on this process can be found at the Transfer Page (link opens new window).

Years Attended
( - )

1    
2    
3    
4    
Your Plans At Bucks County Community College

 

 

 
 

 

Note: If applying for Special Enrollment Status, select AA.0099



 


 

 

Certification of Application

I certify that the information on this application is complete and accurate in every respect. I realize that failure to provide accurate and/or complete information can result in cancellation of this application, and/or revocation of admissions.

   


Services Available

Perkins Academic Support Services are available through the Carl D. Perkins Grant to students seeking Occupational Degrees and Certificates. Eligible students must be single parents, displaced homemakers, academically or financially disadvantaged, or speak English as a second language. Please contact the PASS Office at 215-968-8140 for details of services available.

Disability Services determines and guides the academic adjustments required for the College to comply with Section 504 and the Americans with Disabilities Act (ADA).  Students are encouraged to contact this Office prior to enrollment in order to identify needed adjustments and determine eligibility. Contact the DS Office by phone at 215-968-8463 (V), 215-504-8561 (TDD).

Multicultural Student Services develops and implements programs and services for recruitment, retention, and education of under-represented minority groups and international students. Students are encouraged to contact this Office prior to enrollment for assistance with application requirements and procedures. Contact the Office by phone at 215-968-8107 (V) or online at our website. [Link opens in a new browser window.]


Notice of Campus Security

The Security Information Report required by the College and the University Security Information Act of Pennsylvania and the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act of the Federal government is available through the Office of Security and Safety and other campus locations including our website. [Link opens in a new browser window.]