Online Application

ONLINE APPLICATION

Welcome to Jones College!
You are now ready to begin filling out your application. Please read and follow the instructions for each information field and fill out the application form accordingly.

First Name* _{Please enter a valid name.}

Middle Name* _{Please enter a valid name or NA if you do not have one.}

Last Name* _{Please enter a valid name.}

Suffix

Previous Name Used _{Please enter a valid name.}

Email* _{Please enter a valid email address. Example:bob@email.com}

Mailing Address* _{No special characters allowed}

City* _{Please enter a valid City name.}

State*

Zip* _{Please enter a valid zip code.}

County*

Physical Address Same as Mailing

Physical Address* _{No Special characters allowed.}

City* _{Please enter a valid City name.}

State*

Zip* _{Please enter a valid zip code.}

County*

Home Phone* _{Example 6014774000. Numbers only. No spaces, periods, parentheses or dashes allowed.}

Cell Phone* _{Example 6014774000. Numbers only. No spaces, periods, parentheses or dashes allowed.}

Birthday*

Month

Day

Year

Social Security Number* _{Numbers without dashes.}
I do not have a SSN

Are you a legal US Citizen?*

Parental Type*

Parent's First Name*

Parent's Last Name*

Parent's Address*

City*

State*

Zip*

County*

Parent's Home Phone

Parent's Cell Phone

Parent's E-mail

Optional: The following information is for statistical purposes only. It is not used for admission decisions to the college.

Select one or more of the following categories to describe yourself

American Indian - Alaskan Native
Native Hawaiian/Pacific Islander
Black/African American
Asian
Caucasian/White
Hispanic/Latino

Sex

When you begin attending Jones College, you will be considered a?*

Have you previously been enrolled at Jones?*

Did you take your GED/HiSet in Mississippi?*

What year were you previously enrolled?*

Name were you previously enrolled under?*

High School Information

Please enter the following information concerning your high school. Give full detail such as complete high school name, city and state.

If your high school name does not appear in the Name of High School selection, please choose "Other" under the High School State selection box and type in the name / state of the school you attended.

High School State*

Graduation Year* December Graduate

What term will you be entering Jones?*

What is your proposed area of interest?*

College / University Information

Please list all colleges/universities you have previously attended, beginning with the most recent first. An official transcript must be submitted from each institution and/or high school or both before full admission to Jones County Junior College is complete.

College State

Institutional admission permits students to enter the college. It does not admit applicants to all programs. See the college catalog for programs with additional requirements.

If you plan to live on campus, apply for campus housing at www.jcjc.edu/housing. For information regarding admissions, enrollment, or financial aid, Enrollment Services at (601) 477-4257.

Jones County Junior College does not discriminate on the basis of race, color, national origin, age, sex, or disability in its programs, activities, or employment practices. The following persons have been designated to handle inquiries and grievances regarding the non-discrimination policy: (ADA/ Section 504) Wendy Evans, ADA Coordinator, Terrell Tisdale Library, phone 601-477-2673; email ADACoordinator@jcjc.edu and (Title IX) Brittany Barron, Title IX Coordinator, Hutcheson Hubbard Administration Building, phone 601-477-4127; email brittany.weatherford@jcjc.edu. Jones County Junior College, 900 South Court Street, Ellisville, MS 39437.

I CERTIFY ALL INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.

Signature*

Date