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Joint Admission Agreement Form

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.

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

Metropolitan Community College - Kansas City

North Central Community College

Southwestern Community College

Name

* First Name

Preferred First Name

Middle Name

* Last Name

Former Last Name(s)

Permanent Address

Permanent Address

* Address Line 1

Address Line 2

* City

* State

* Zip / Postal Code

Cell Phone

* Country Code

Phone Number

* Opt in for SMS

I would like important updates sent to me via text/SMS messaging. (Standard message charges apply.)

General Info

* Date of Birth

* Email

Enrollment Info

What is your intended major at Northwest:

* Which of the following will be your primary attendance location?

* When do you plan to enroll at Northwest?

By submitting this application, I certify that I have read the guidelines for participation in the Joint Admission Program between Northwest Missouri State University and my community college.

By submitting 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 submitting below, 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/technology-policies.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.

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