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Northwest Missouri State University

Joint Admission Agreement Form

Complete this form to initiate your participation in the joint admission agreement between Northwest Missouri State University and your community college. As a program participant, you will enjoy the benefits of being a student at each school whether you are enrolled in only one school, alternate enrollment between the two institutions or co-enroll in both institutions at your discretion. View the complete list of program guidelines and benefits »

I would like to participate in the joint admission agreement between Northwest Missouri State University and

Name
Permanent Address
Current Address
    1. Same As Permanent
Phone
  1. - -
  2. - -
General Info
How do you prefer to be contacted?
  1. Contact Preference:
When do you plan to enroll at Northwest?
    1.  Enrolling in 
    1.  Currently enrolled at Northwest - plan to enroll in NCMC nursing
          program in 
I have read the guidelines for participation in the Joint Admission Program between Northwest Missouri State
     University and my community college.

By signing below, I certify that I wish to become a participant in the Joint Admission Agreement between Northwest Missouri State University and my community college. I am aware that my participation in this agreement will continue for three years unless I request in writing to be taken out or I discontinue courses at both institutions. I understand that my participation under this agreement will require the two institutions to share my demographic information and my academic information contained in my educational records maintained by them that relate to my high school experience and/or my time as a student at either institution. Therefore, this constitutes a written consent within the meaning of FERPA to the sharing of that information. I further understand that additional documentation may be required when I decide to become a full-time student at Northwest Missouri State University.

By signing this application, I am also accepting Northwest Missouri State University’s computer policies as stated in the User’s Guide, available on the internet at www.nwmissouri.edu/compserv/clientcomputing/ComputingPolicies.htm. Acceptance of the Northwest Computer Policy is required before a computer username will be issued, to gain access to the computing services provided by Northwest.