Honors Program Application

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First Name: *

Middle Name:

Last Name: *

Email *Enter your email address

Ideal Telephone Number:Please enter the best phone number to contact you.

Mailing Address Line 1:

Mailing Address Line 2:

City: *

State: *

Zip Code: *

Student Type *

Please do not exceed 4,000 characters in the answers below.

Please describe any recent activities and awards from high school, college and/or the community. *

Please describe your current hobbies and interest. *

Please indicate your current academic major or curriculum of interest and/or your career goal. *

List any advanced placement or honors courses taken in high school or college.

Why are you interested in the Honors Program at Clinton Community College? *

I certify that the information on this application is correct. False information may result in denial of admission or administrative dismissal from the Honors Program at Clinton Community College.

Clicking submit will act as a formal signature for this form.