Application Form - Gateway Technical College

To apply to a program or certificate, complete the WTCS Application for
Admission. The application can be found online at www.gtc.edu/forms.
Please be sure to answer all questions.
Application
Form
While Gateway Technical College
accepts applications on
an ongoing basis, we do have
priority admission dates prior to
the start of each semester.
Summer Semester: January 1
Fall Semester: March 1
✓ Pay your non-refundable $30 application fee either
online at www.gtc.edu/webadvisor or at a Gateway
campus near you.
✓ Check www.gtc.edu/admissions for other program
admission requirements and to answer questions you
may have.
✓ Sign up for your placement assessment. One assessment
is included in your application fee. The assessment is
$15 for those who do not pay the application fee. Fees
apply to additional testing appointments.
✓ We strongly urge you to review prior to the assessment.
Study materials are found at www.gtc.edu/testing.
✓ Request official high school, GED/HSED, and college
transcripts from schools attended. To be considered
official, transcripts must be mailed directly from the
issuing school to Gateway Technical College.
✓ Don't wait! Apply for Financial Aid online at www.
fafsa.ed.gov. You can complete your application for
admission and financial aid at the same time.
✓ Register for classes online at www.gtc.edu/webadvisor.
You can register for any classes for which you meet the
prerequisite.
✓ See your advisor for assistance with course selection and
academic planning.
Those applying to programs not requiring an application fee, payable to Gateway, must pay for
their placement assessment prior to taking it.
You DO NOT need to submit $30 along with your application if you are applying to:
Adult High School
Nursing Assistant
Emergency Medical Services (EMS)
IV Technician
Advanced Technical Certificates
Apprenticeships
Gateway (Internal) Certificates
Spring Semester: November 1
Complete your file for admission
by the dates above and we
guarantee admission to your
program by Priority Student
Registration!
If you have any questions about this application or programs that are available, please contact a Student Services Counselor at a
campus near you. Services for learning or physically disabled students are available by contacting Student Services.
Burlington Center . . . . . . . . . . . . . .
Elkhorn Campus . . . . . . . . . . . . . . .
Kenosha Campus . . . . . . . . . . . . . .
Racine Campus. . . . . . . . . . . . . . . .
262.767.5300. . . . . .
262.741.8300. . . . . .
262.564.2300. . . . . .
262.619.6300. . . . . .
262.767.5206 TTY
262.741.8206 TTY
262.564.2206 TTY
262.619.6206 TTY
Gateway Technical College is an equal opportunity/Access/employer and educator.
Ofrece igualdad en opportunidades/acceso/empleo y educación.
052012-ak-3000
ATCs
Computer Animation (10-810-18)
Digital Photography (10-810-17)
Financial Planning (10-809-8)
Game Programming (10-810-16)
Geothermal Specialist (10-810-19)
Gerontological and Rehabilitative Nursing Care (10-810-21)
IBM Enterprise Programming and Administration (10-810-11)
Mobile Applications Development (10-810-22)
Multimedia (10-810-2)
Network Security (10-810-10)
Oracle (10-810-4)
Telecommunication Engineering Tech (10-810-14)
Urban Farming (10-810-20)
APPLICATION FOR ADMISSION
PLEASE PRINT C L E A R LY I N I N K
1. Legal name: Last
First
10. Date of Birth (MM/DD/YY)
Middle
11. Gender:  Male  Female
2. Former last name(s) (if applicable)
12. Are you a U.S. Veteran?  Yes  No
13. Are you a U.S. Citizen?  Yes  No If yes, skip to #14;
3. Current mailing address
13a. Are you in the U.S. on a Visa?
4. City
State
Zip Code
 No
13b. Do you have a U.S. permanent resident card?  Yes  No
If you are not a U.S. Citizen or permanent resident, provide:
5. Permanent address (if different)
Visa Type
6. City
(
)
7. Primary phone number
 Yes
State
Zip Code
Visa No.
14a. I am a legal resident of (circle one) City/Village/Township
(
)
Secondary phone number  Home  Cell  Work
14b.
City/Village/Township
County
State
8. E-mail address
15. Name of high school district in which you now reside
9. Social Security Number
The following questions are confidential. Your responses will help the technical college evaluate recruitment and retention practices and will not
affect admission to the college.
16. Select highest degree earned by either parent:  High school diploma  Associate degree  Bachelors degree  Masters or beyond
The following questions relate to racial and ethnic identity. Please respond to both questions.
17(a). Are you Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race)?
 Yes
 No
17(b). Select any other group or groups that apply to you.
 American Indian or Alaska Native. A person whose ancestors include native peoples of North and South America (including Central America),
and who maintains a tribal affiliation or community attachment.
 Asian. A person whose ancestors include native peoples of the Far East, Southeast Asia or the Indian subcontinent (including, for example,
Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam).
 Black or African American. A person whose ancestors include any of the black racial groups of Africa.
 Native Hawaiian or other Pacific Islander. A person whose ancestors include the native peoples of Hawaii, Guam, Samoa or other Pacific Islands.
 White. A person whose ancestors include native peoples of Europe, the Middle East or North Africa.
18. I wish to attend
Technical College at
19. Have you attended this college before?
20. Semester you wish to begin:  Fall
 Yes
 Spring
 No
Campus
If yes, last year and semester attended
 Summer (if applicable) Year
21. Program/major choice
Program number (if known)
22. Name of last high school attended
23. Are you a high school graduate?  Yes
City
 No
24. If you did not complete high school and receive a diploma, have you completed either the GED® Tests
If yes, date completed (mm/yy)
25. Circle or identify highest grade completed: 8
State
If yes, please enter your graduation date (month/year)
 Yes
 No
or HSED?
 Yes
 No
Test center
9
10
11
12
13
14
15
16
17 (Other)
26. Select highest credential received:




Some college (postsecondary credit)
Short-term diploma
1-year diploma
2-year diploma




Associate degree
Associate degree plus addtional credential
Baccalaureate
More than baccalaureate
27. List previous colleges and universities attended (official transcript will be required for credit transfer)
Name
City
State/Province
Date attended
Date graduated
28. I certify that the information on this application is true and complete to the best of my knowledge
Date
Signature
STATEAPP 05/12
hnical College System
keting
3707-7874
NO POSTAGE
NECESSARY
Blackhawk
IF MAILED
IN THE
Chippewa ValleyUNITED STATES
S MAIL PERMIT NO. 1756 MADISON WIGateway
Lakeshore
Name:
General Instructions
Madison College
F WISCONSIN
MENT OF ADMINISTRATION Mid-State
7840
N WI 53791-8890
Milwaukee Area
3707-7874
COMPLETING THE APPLICATION FOR ADMISSION
HighFOR
School
Graduation Date
This application form is the first step toward admission to any program (major) in the Wisconsin Technical
College System. Once the college receives the form and
appropriate fee, it will send you further information on
 Programs/Majors:
requirements and/or procedures.
INESS REPLY MAIL
hnical College System
keting
INSTRUCTIONS
I am considering attending college at this (these) technical college location(s):
Fox Valley
WILL BE PAID BY ADDRESSEE
I want to start or update my career
at a Wisconsin technical college (Please Print)
Address:
•
Complete all sections of the form.
City/State/Zip:
• Please print clearly.
• Consult
Phone
number:the
( college
) of your choice for application dates,
specific program (major) information and other details.
E-mail:
•
If you wish to apply for admission to more than one Wis-
Preferred
method
of contact:
 submit
Phone a
E-mail application
 Postal mail
consin
technical
college,
separate
Moraine Park
Nicolet Area
•
Northcentral
Application
Fee
I want
Northeast Wisconsin
NO POSTAGE
Southwest
NECESSARY
WisconsinIFINMAILED
THE
UNITED STATES
Waukesha County
Western
INESS REPLY MAIL
S MAIL PERMIT NO. 1756 MADISON
WI
Wisconsin
Facebook: wistechcolleges
F WISCONSIN
MENT OF ADMINISTRATION
7840
Twitter: wistechcolleges
N WI 53791-8890
S MAIL PERMIT NO. 1756 MADISON WI
WILL BE PAID BY ADDRESSEE
F WISCONSIN
MENT OF ADMINISTRATION
7840
N WI 53791-8890
application you complete. Send a check or money
High School
Graduation Date
order made out to the college; do not send cash.
Each application
must
include
the(these)
$30 application
fee. location(s):
I am•considering
attending
college
at this
technical college
•
The $30 fee (per college) is a one-time-only fee.
Name:
•
Request official copies of all academic transcripts,
including high school, Tests of General Educational
Development (GED® Test), HSED, college or university.
Contact each institution and ask to have your official
City/State/Zip:
transcripts mailed directly to the Admissions Office of the
are applying.
Phonecollege(s)
number: (to which you
)
Address:
If you are still enrolled in high school, send a transcript
of the courses you have completed, along with a list of
Preferred
Phone
 E-mail  Postal mail
the method
coursesoftocontact:
be takenprior
to graduation.
•
E-mail:
 Other
Testing/Assessment
Youtube: wistechcolleges
INESS REPLY MAIL
to start or update my career
(Please Print)
atthea$30
Wisconsin
• Attach
nonrefundabletechnical
application feecollege
to each
Transcripts
WILL BE PAID BY ADDRESSEE
3707-7874
Apply early!
 Programs/Majors:
Indianhead
hnical College System
keting
 Other
form and application fee directly to each college.
•
Many Wisconsin technical colleges require testing for
acceptance into specific programs. Test results are generally used to
place youto
in courses
programs where
I want
startand/or
or update
my career
you can succeed academically.
at a Wisconsin technical college
(Please Print)
If you have taken the ACT or SAT, please send your
High School
Graduation Date
score report to the college.
•
NO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES
Contact theattending
college college
for testing
requirements.
I am•considering
at this
(these) technical college location(s):
•
Accommodations are available for students with
special needs.
 Programs/Majors:
Disclosing Your Social Security Number:
Name:
The Wisconsin Technical College System may request and use
Address:
your social security number for record keeping and statistical
purposes related to auditing, enforcing and evaluating Federally-
City/State/Zip:
supported education programs (Federal law 20 U.S.C. § 1232g
(1998)). You are required to provide your social security number
Phone
number:
)
if you
are, or( will be, applying
for financial aid. If you will not
be applying for financial aid, then providing your social security
E-mail:
number is optional. However, there may be a delay associated
with processing
application
while an
is mail
Preferred
method ofyour
contact:
 Phone
alternate
E-mail number
 Postal
assigned.
GED® and GED Testing Service® are registered trademarks of
the American Council on Education® and may not be used or
 Other