MR. MRS. MS. MISS
NAME:

ADDRESS:

CITY:

STATE:

ZIP:

PHONE:

E-MAIL ADDRESS:

SOCIAL SECURITY NUMBER:

BIRTH DATE:

HIGH SCHOOL:

COURSE OF STUDY:

GRADUATION DATE:

OTHER SCHOOLS OR COLLEGES ATTENDED:

NAME OF PROGRAM TO STUDY: (check one)
----- Associate in Specialized Business Degree Programs -----

Accounting
Administrative Office Technology
Medical Assisting
Network Administration
Computer Science & Programming
Cosmetology
Criminal Justice
Office Technology—Medical
Marketing and Management
Paralegal
Professional Massage Therapy
Early Childhood Education
Surgical Technology

----- Diploma Programs -----

Accounting Assistant
Medical Office Assistant
Clinical Office Assistant
Office Assistant
Massage Therapy
Computer Office Support
Computer Programming Technology
Cosmetology
Microcomputer Applications
Nail Technology
Skin Care Technology

CAMPUS LOCATION:
POTTSVILLE    HAZLETON   SUNBURY DICKSON CITY

CLASSES:
DAY   EVENING

STARTING TERM:
FALL    WINTER    SPRING    SUMMER

METHOD OF FINANCING: (check all that apply)
GRANTS
STUDENT LOANS
VETERANS BENEFITS
SAVINGS
OTHER -

COMMENTS/QUESTIONS:

Please remember that this is only a pre-application for admission and an admissions representative will contact you. To complete the admission process, you must visit the campus and complete an interview with our admissions representative, submit a paper application, and a $40 dollar application fee. Thank you for your interest in McCann School of Business & Technology. We look forward to meeting with you soon.