Continuing Education Application

Personal Information

General Information

First Name

Middle Name

Last Name

Suffix

Former Last Name

Sex

Would you like to provide more information about your gender identity?

Birthdate

Contact Information

Permanent Address

Country

Street

City

Region

Postal Code

Mailing Address is different than Permanent Address *

Mailing Address

Country

Street

City

Region

Postal Code

Phone

Email Address

Demographics

Citizenship Status

Country of Citizenship

Dual Country of Citizenship

How would you describe your ethnicity?

How would you describe your race?

U.S. Veteran Information

Military Affiliation

Military Branch

Financial Aid Information

Are you applying for Federal Financial Aid?

Have you already submitted a FAFSA?

Yes

No

Social Security Number

Enrollment Information

Anticipated Enrollment

I will be starting at Nichols as a

I prefer to take classes

I would like to start my studies in

I would like to enroll in the following degree program

Major or Concentration

Academic Information

General Academics

Highest level of education?

How many credits do you intend to transfer?

Will you have your associates before you start?

Please list schools in order of attendance starting with school most recently attended. If you plan on transferring 24 or more credits, you do not need to list your high schools.

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Add Academic History
Institution Name Institution CEEB Start Year End Year

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Certify and Sign

How did you hear about Nichols College?

My electronic signature confirms that all personal information entered is true and accurate to the best of my knowledge and I agree to be contacted by representatives of Nichols College for admission and enrollment purposes.

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