Student Application

This application is to be filled out by the individual who is applying to attend F.I.R.S.T. Institute.

Student Application

"*" indicates required fields

Please note that your information is saved as you enter it for your convience.

Step 1 of 3

PERSONAL INFORMATION

(YOUR FIRST LEGAL NAME, AS IT APPEARS ON YOUR ID OR STATE ISSUED IDENTIFICATION)
(YOUR LAST LEGAL NAME, AS IT APPEARS ON YOUR ID OR STATE ISSUED IDENTIFICATION)

CONTACT INFORMATION

PROGRAM OF CHOICE FOR F.I.R.S.T. INSTITUTE

Please select the program you are applying for at F.I.R.S.T. Institute.

PHYSICAL ADDRESS INFORMATION

Permanent Home Address*
Gender*
Select date MM slash DD slash YYYY

YOUR ADMISSIONS REPRESENTATIVE

Have you worked with an Admissions Representative yet?*

CRIMINAL HISTORY

By submitting this application, you agree to immediately notify the school should there be a change of circumstances that affects the accuracy of your answers in this section between the date you submit your application and your first day of classes.

Have you ever been convicted of a criminal offense, found guilty, or entered a plea of guilty or no contest, regardless of adjudication?*

List all the offenses and/or pending charges, the date of each offense/charge, and the date of each conviction/adjudication. Also, describe the circumstances surrounding each offense/charge and if you wish, you may provide a statement as to why you believe this information should not be cause for concern about the safety of the F.I.R.S.T. Institute Community.

EMERGENCY CONTACT INFORMATION

ETHNICITY/DEMOGRAPHICS

F.I.R.S.T. Institute does not discriminate regarding sex, age, race, color, disability, national origin, creed and/or religion. Federal law requires that institutions of higher education gather the following information regarding the ethnicity and race of its students and employees. Your individual information will be kept strictly confidential. The information is intended solely for federal statistical and reporting purposes and will not be used as a factor in the admissions process.

Select one or more of the following races*
Are you a U.S. citizen or a permanent resident?*
Is English your primary language?*
Applicants whose primary language is not English must demonstrate the required level of language proficiency.