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More Information - Online Application

Personal information
First Name	Last Name	MI	Age

Address	City	State	Zip
Phone	Email	Employed?
Will your employer provide tuition reimbursement?		Percentage

Education information
I have graduated from high school or have passed the GED Exam. YES
List all colleges and/or institutions you have attended in the past including Potomac College if you were a student previously.
Date From	Date To:	College Name	Aprox. Credits

Military information

Have you served in the armed forces? (if yes, which branch?)

Desired major
Bachelor's program	Associate's program

Important
I certify that the information given on this application is complete and correct to the best of my knowledge, and I have attended no colleges or institutions other then those listed. I understand that the official transcripts forwarded from the schools become the property of Potomac College and will not be returned to me. I also understand that acceptance to Potomac College is subject to verification of information provided and official records sent directly from the institutions I have attended.
Please type "agree" (lowercase)	Date

Potomac College admits students to all programs and activities, and administers all education, employment, and other policies without discrimination based on race, creed, sex, sexual preference, religion, national or ethnic origin, or handicap.

How did you hear about us?

"...Potomac College fits into my busy life style"

"I travel a lot in my business and feel like Potomac College fits into my busy life style. Potomac College has flexible classes, both weekdays and weekends." -Potomac graduate

We work for the working professional