Part-time Application | Capitol College

Please use the form below to apply for part-time status only. If you are applying for full-time status, please use the full-time undergraduate application for admission.

Personal Data

Title: *

Mr.

Ms.

Miss

Mrs.

First Name: *

Middle Initial:

Last Name: *

Maiden/Other:

Street Address: *

Address (continued):

City: *

State: *

Zip/Postal Code: *

Country: *

Email: *

Home Phone: *

Gender: *

Male

Female

Marital Status: *

Birthdate: *

Birthplace: *

Predominant Ethnic Background:

(To be used only for required Federal reports)

Are you a:

U.S. citizen

Permanent resident

Alien registration number:

If you are not a U.S. citizen or a permanent resident, you must complete the international student application