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Mount Marty College
Application for Admission Watertown Campus
PERSONAL DATA
Your First Name*:
Middle Name:
Last Name*:
Preferred Name:
Former Name[s]:
Social Security Number:
Permanent Address:
City:
State:
Zip:
Country:
Current Address:
City:
State:
Zip:
Country
Main Phone Number*:
Cell Phone:
E-mail Address:
Citizenship
U.S. Citizen Permanent Resident Foreign Student
 
How would you prefer to be contacted?
Phone Cellphone Mail Email Text
ENROLLMENT DATA
Term of Attendance: Fall Spring   Summer   Year
Degree Sought: Bachelor           Associate          Certificate
Bachelor 2+2   Bachelor 1+3
Entering Status: First-time Freshman   Transfer
Intended Load: Full-time(12-18 credits)   Half-time(1-11 credits)
Financial Assistance: I will apply   I will not apply
Residency Status: On-campus  Off-campus   Off-campus with parents
Degree Program: Regular Program   Accelerated Program
 
What influenced you to apply to Mount Marty College?
Academic Program
Enrollment Counselor Reputation
Alumni
High School Visit Scholarships
Coach
Location Current Student
College Guidebook
Mailings Professor
Church Leader
Print Advertisement Website
College Fair
Parents, Friends or relatives Other
Campus Visit
Radio Advertisement  
ACADEMIC DATA
Program Areas of Interest  
Accounting (BA & AA)
Applied Technology Management (BA with LATI graduates)
Business Administration (BA &AA)
Criminal Justice (BA &AA)
Elementary Ed. (BA)
Human Services (BA)
Information Technology (BA with LATI graduates)
Interdisciplinary Studies (BA &AA)
Nursing (BS)
Psychology (BA)
Undecided
 
PERSONAL DATA
Please note: This information is optional and will not affect any admission decision. It is used for institutional research and reporting only.
Marital Status:
Gender:
Male Female
Date of Birth:
U.S. Citizen or Legal Resident:
Yes No
If No, country of citizenship:
Religious Preference
Occupation:
Place of Employment:
 
Ethnicity:
Non-Hispanic-Latino
Hispanic-Latino
Race:
EDUCATIONAL DATA
Please list high school attended:
Name of School
City
State
Dates Attended
Graduation Date
Have you received your GED (General Development Test)? Yes No
Have you taken the ACT? Yes No
Have or will you have taken Advance Placement (AP) exam(s) for credit? Yes No
Have you taken College Level Exam Program (CLEP) exam(s) for credit? Yes No
Have you received any college credit for military training? Yes No
Please list post-secondary institutions attended, beginning with the most recent:
Name of Institution
City
State
Dates Attended
Graduation Date
FAMILY DATA
Name of Parent(s) with whom you reside:
Occupation(s) of parent(s):
Siblings (include names and grade level):
Spouse's Name:
Children (include names and ages):
List of family members who have attended Mount Marty College and their relationship to you:
INTERNATIONAL DATA
(If Applicant is not a U.S. citizen, please complete the following)
Country of Residence Country of Birth
Choose One: Immigrant Permanent Resident in the U.S. (green card holder)
Alien Registration Number:
Type of Visa:
If already in the United States, your date of entry:
TOEFL Score: Date TOEFL taken:
COLLEGE PLANNING DATA
How do you think a college education will help you fulfill your future goals and why would you like to attend Mount Marty?

List the colleges you are considering, including Mount Marty:
First Choice:
Second Choice:
Third Choice:
Fourth Choice:
DISABILITY ACCOMMODATIONS
Accommodations are provided in accordance with Section 504 of the Rehabilitation act of 1973 and the Americans with Disabilities Act of 1990 for eligible students upon request. Eligible students must provide documentation that appropriately substantiates the need for requested accommodations. If you need accommodations, please contact the Disabilities Services Office at 668-1518. Forms and information on the accommodations web process can also be found on the Disabilities Services webpage under Student Life.
CONFIRM AND SUBMIT
I realize this application becomes a part of my permanent record at Mount Marty College. Having completed this application to the best of my ability, I hereby request admission to Mount Marty College. By submitting this application, you are confirming that the information contained on this application is correct, complete, and honestly represented.

Mount Marty College specifically prohibits discrimination in its policies and practices against any individual for reason of race, color, creed, age, national or ethnic origin, handicap, disability or gender.

Send Required Materials To: Mount Marty College
Admissions Office
3100 9th Ave SW
Watertown, S.D. 57201-6385
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