Entry-level IT Help Desk Technician - SUNY Westchester Community College

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Application

Legal First Name *

Legal Last Name *

Date of Birth *

M/D/Y

Gender

Male

Female

Address *

Apt, suite, etc.

Country

City

State

Zip code

Home Phone

Cell Phone *

Email *

Ethnicity

A variety of government agencies require that institutions of higher education report student enrollment by ethic status. The information requested in this section will assist with meeting this requirement. Please check the appropriate box (Response is optional and will not affect your admission into the program.)

Are you Hispanic/Latino

Yes

If Hispanic/Latino

please indicate which of the following best describes your background (select one)

Cuban

Dominican

Other Hispanic/Latino

Puerto Rican

Mexican

Academic History

Did you graduate from high school?

Yes

Name of High School

Date you graduated from High School?

Did you receive a General Education Development (GED) Certificate/Diploma?

Yes

Have you ever been dismissed from college for academic reasons?

Yes

Have you ever been dismissed from college for disciplinary reasons?

Yes

Date

Captcha *

reCAPTCHA is required.