Chesapeake College Admissions Application
Content
Chesapeake College Admissions Application
FOR OFFICIAL USE ONLY
P.O. Box 8, Wye Mills, MD 21679
Web address: www.chesapeake.edu
(410) 822-5400; 758-1537; 228-4360 Fax #: 410-827-5878
TTY Users: Call via Maryland Relay
Date: ________ Semester: _________
Stud. ID #: ______________________
Please print clearly. Use black or blue ink. Check the appropriate boxes and complete entire application. No application fee is
required. Please return completed application to: Chesapeake College, Office of Admissions, P.O. Box 8, Wye Mills, MD 21679.
PERSONAL INFORMATION
Social Security numbers are used by the College to ensure the integrity of
student records and to meet federal government reporting requirements. They
are also needed for Scholarships and Financial Aid.
Social Security
Number:
Last Name (Legal):
First Name:
Other Names (i.e. maiden):
Full Middle Name:
Date of Birth:
(month/day/year)
Current Address
Street Number and Name/Apt. # :______________________________________________________________________________________________ P.O. Box #: __________________________________
City:
How long have you lived at your current address?
State:
Zip Code:
Less than 3 months
3 months or more
If less than 3 months, list previous address:
Street Number and Name/Apt. # :___________________________________________________________________________________ P.O. Box #: __________________________________
City:
Length of time at previous address:
State:
Months:
Zip Code:
Years:
County of Residence:
Phone Numbers:
005 Caroline
017 Queen Anne’s
Other MD County (write below):
009 Dorchester
020 Talbot
___________________________
014 Kent
040 Out-of-State
099 Out-of-Country
Home:
___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Cell:
___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Email:_____________________________________________________________________________________________________________________________________________
I certify that the following information is correct and complete to the best of my knowledge:
I am a dependent of and live with my parent(s) or guardian(s) at the Current Address given above.
I was claimed by my parents in the previous tax year.
Yes
If yes, what is their legal state of residence? _____________________________________
Gender:
Male
Yes
No
No
If Maryland, what county? ______________________________________
Female
How many hours do you spend in a typical 7-day week:
Working for pay:
None
1-5 hours
6-10 hours
Providing care for dependents living with you:
None
11-20 hours
1-5 hours
21-30 hours
6-10 hours
More than 30 hours
11-20 hours
21-30 hours
More than 30 hours
ETHNICITY INFORMATION
The following information is gathered for purposes of meeting state and federal agency requirements. This information is not used for admission to
Chesapeake College.
Part 1: Please select the group which most closely represents you:
Hispanic/Latino (HIS)
Part 2: Please select one or more of the following groups which most closely represents you:
American Indian or Alaska Native (AN)
Asian (AS)
Black or African American (BL)
Native Hawaiian or Other Pacific Islander (HP)
White (WH)
Non-Hispanic/Latino (NHS)
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MILITARY STATUS
Are you a veteran or a dependant (including spouse) of a veteran?
Yes
If yes, check one:
Veteran
Dependant
If you are active duty military, where are you stationed? ________________________________________________________________________ (To be considered for incounty or in-state tuition due to BRAC, you will need to provide your orders to the Registration office at the Wye Mills Campus for verification.)
CITIZENSHIP INFORMATION
CITIZENSHIP
(Please check one option)
U.S. Citizen (US)
Permanent Resident (RA)
(The applicant must present the Permanent Resident Card to the Admissions Office staff at the Wye Mills Campus for
verification prior to college acceptance.) A copy of the Card will be made and included with this admissions application. In the absence of documentation, a
student is charged out-of-state tuition and fees.
Non-U.S. Citizen (NA) (If you checked Non-U.S. Citizen, you must state your country of citizenship here: ___________________________________________)
Are you here on a VISA?
Yes
No
If yes, state type of VISA: ________________________________________________
VISA #: ______________________________________________________________________________________________
To all VISA Holders: You must submit your original documentation to the Admissions Office at the Wye Mills campus for verification prior to college
acceptance.
Country of Citizenship: _______________________________________________________
Do you plan to enroll at Chesapeake College as a visiting student and maintain an F1 status at your home school?
Yes
No
All VISA students must contact the Registrar at Chesapeake College for admission and enrollment information and procedures.
Application deadlines for International Students:
June 1 for the Fall semester
November 1 for the Spring semester
PERSONS TO CONTACT IN CASE OF EMERGENCY
Last Name:
Relationship to you:
First Name:
Parent/Guardian
Spouse
Last Name:
Relationship to you:
Middle Initial:
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Other
First Name:
Parent/Guardian
Spouse
Middle Initial:
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Other
FIRST-GENERATION STUDENT INFORMATION
Your parent’s educational level:
▪ Less than high school
▪ Completed high school or GED
▪ Some college, but no degree
▪ Two-year college degree
▪ Four-year college degree
▪ Advanced degree (Graduate or Professional)
▪ Unknown
Semester/Year applied for:
Mother
SEMESTER START STATUS
Fall (Aug.-Dec.)
Are you applying for Financial Aid?
Father
Spring (Jan.-May)
Yes
Summer (June-Aug.)
Year 20__ __
No
Academic Goal
Admission Status: (check one)
(FF) First-time Freshman (never attended a college/university after
Please check the one statement which most closely corresponds to your primary reason for
attending Chesapeake College:
high school)
(HS) High School (attending while still enrolled in high school)
(ND) Non-Degree seeking (taking courses WITHOUT intention
of earning a Chesapeake College degree)
(R3) Returning Student (returning to Chesapeake after absence of
three semesters or longer)
(RT) Returning Student (returning to Chesapeake after absence of
less than three semesters)
(TR) Transfer (transferring from another college to Chesapeake)
1). Exploration of new career or academic area
2). Preparation for immediate entry into a career
3). Preparation for transfer to a four-year institution
4). Preparation for a job I currently hold
5). For interest and self-enrichment
6). Visiting student
(VS) Visiting Student (enrolled at another college and planning to
transfer Chesapeake College coursework back to home institution)
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SECONDARY SCHOOL INFORMATION
From which high school did you graduate or will you graduate?
Year of graduation: ____________
210318 Cambridge-South Dorchester
210994 Kent Island
210469 Wesleyan Christian School
210491 Chesapeake Christian School
210477 North Caroline
219300 Out-of-State High School
210525 Colonel Richardson
210655 North Dorchester
210490 Easton
210364 Queen Anne’s County
219501 Home-Schooled
210496 Sts. Peter & Paul
211095 Kent County
210925 St. Michaels
219100 Other Maryland School
Please list: _____________________
Did you graduate from a local high school CTE (Career and Technology Education) Program?
Yes
No
GED Students: Please complete the following section.
219200 Maryland GED
Year earned: _______________
219400 Out-of-State GED
Year earned: _______________
I am interested in attending Chesapeake College, but have not graduated from a high school nor earned a GED.
(Note: Applicants who checked the box above will not be denied admission to Chesapeake College.)
COLLEGE OR UNIVERSITY ATTENDANCE
I have earned college credit at other colleges or universities since high school graduation.
Yes
If yes, what is the highest degree you have earned?
Master’s
Associate’s
Bachelor’s
No
Doctorate
PRIOR COLLEGES/UNIVERSITIES ATTENDED (Please list all institutions starting with the most recent. Use separate sheet if necessary.)
NAME
CITY AND STATE OR COUNTRY
DATES ATTENDED
DEGREE
________________________________________________________
________________________________________
_______________________
___________
________________________________________________________
________________________________________
_______________________
___________
________________________________________________________
________________________________________
_______________________
___________
BACHELOR’S DEGREE PROGRAMS – EASTERN SHORE HIGHER EDUCATION CENTER
Salisbury University and University of Maryland - University College offer the junior and senior years of the following Bachelor’s Degree Programs at the
Higher Education Center located on the Wye Mills Campus. If you intend to complete your Bachelor’s Degree at the Higher Education Center, please
check the appropriate intended degree program box.
Salisbury University
Social Work
Elementary Education
University of Maryland - University College
Business Administration
Criminal Justice
AREA OF STUDY - PROGRAM/MAJOR CODE
It is important that you complete this section to ensure a correct selection of your College Major Code. Please turn to the back page of
this application and write in your three-digit Program/Major Code. ____ ____ ____
Note: Chesapeake College reserves the right to award students all academic credentials earned, including certificates and degrees.
HONOR CODE FOR CHESAPEAKE COLLEGE
Students of Chesapeake College agree to demonstrate academic and personal integrity. Chesapeake College students are persons of integrity: they stand for that which is right.
They tell the truth and ensure that the full necessary truth is known. They do not lie. * They embrace fairness in all actions. They ensure that work submitted as their own is
their own, and that assistance received from any source is authorized and properly documented. They do not cheat. * They respect the material and mental property of others
and ensure that others are able to benefit from the use of their own property. They do not steal. * Therefore, each student at Chesapeake College pledges to:
♦ Submit assignments that reflect his/her own thoughts and work
♦ Cite and properly acknowledge the thoughts and work of others
♦ Complete all test and other in-class assignments using his/her own thoughts
♦ Reject the use of materials acquired illegally
♦ Respect the rights and property of others
Those found to be in violation of this code agree to disciplinary sanctions and appeal processes outlined within the Chesapeake College Student Code of Conduct.
* Adapted from the U.S. Naval Academy Code of Honor
APPLICANT’S AGREEMENT (Please read carefully and sign)
In making this application, I accept and agree to abide by the policies and regulations of Chesapeake College. I certify that the information on this application is complete and
accurate. Failure to provide accurate information, particularly in the case of residency, may be just cause for dismissal from the college. I understand that it is my responsibility
to notify the Office of Registration of any change in the information contained in this application.
Applicant Signature: _________________________________________________________________________________________________ Date: _______________________________________
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AREA OF STUDY - PROGRAM/MAJOR CODE
Please circle ONE Program/Major Code in the section below and write in your three-digit program in the “AREA OF
STUDY - PROGRAM/MAJOR CODE” section on page 3. Detailed information about programs of study, including course
requirements and course descriptions, can be found in the online College catalog at www.chesapeake.edu.
Any Program/Major marked with an asterisk (*)is not eligible for Financial Aid.
Accounting/Business
Education/Teaching (continued)
Human Services
Accounting (410) A.A.S.
Advanced (412) Certificate
Basic (411) Certificate
Tax (413) LoR*
Business Administration (350) A.A.
Business Management Tech. (401) A.A.S.
Business Management Tech. (402) Certificate
Business Management Tech. (403) LoR*
Secondary Education-English (310) A.A.T.
Secondary Education-Mathematics (307) A.A.T.
Secondary Education-Physics (308) A.A.T.
Teacher Aide (345) Certificate
Mental Health (682) A.A.S.
Substance Abuse/Addiction (683) A.A.S.
Liberal Arts and Sciences
Health, Fitness & Exercise Science
Exercise Science (151) A.A.
Exercise Science (158) Basic Certificate*
Exercise Science (159) Advanced Certificate*
Exercise Science/Allied Health (155) A.A.
Sports Management (160) A.A.
Sports Management (168) Basic Certificate*
Sports Management (169) Advanced Certificate*
Agriculture & Environmental Studies
Landscape Architecture (390) A.S.
Landscape Management (395) A.S.
Computer Studies
Computer Information Security (495) A.A.S.
Computer Information Systems:
Interactive Media/Web Design (474) A.A.S.
Advanced (491) Certificate
Basic (492) Certificate
Interactive Media/Web Design (453) LoR*
Microcomputer Applications Specialist (486) A.A.S.
Advanced (496) Certificate
Basic (497) Certificate
Micro. Applications Specialist (455) LoR*
PC & Network Management (477) A.A.S.
Advanced (478) Certificate
Basic (479) Certificate*
Criminal Justice
Engineering Technology
Drafting and Design (743) A.A.S.
Drafting and Design (742) Certificate
Drafting and Design (745) LoR*
Welding
Advanced (776) Certificate
Basic (775) Certificate
Welding (763) LoR*
Paralegal Professions
Paralegal Studies (620) A.A.S.
Paralegal Studies (622) Certificate
Technical/Professional Studies
Technical/Professional Studies (400) A.A.S.
Environmental Science
Undeclared Majors or Transfer
Certificates (150 and 250)*
Environmental Science (360) A.S.
Environmental Monitoring (364) Certificate
Land Use Management (405) LoR*
(Students in an undeclared major or
transfer certificate are NOT eligible for
financial aid.)
Health Professions
Corrections (604) A.A.S.
Corrections (608) Certificate
Crime Scene Technician (607) A.A.S.
Crime Scene Technician (605) Certificate
Law Enforcement (602) A.A.S.
Law Enforcement (606) Certificate
Education/Teaching
Early Childhood Development (641) A.A.S.
Advanced (642) Certificate
Basic (645) Certificate
Early Childhood Development (643) LoR*
Early Childhood Education/Early
Childhood Special Education (309) A.A.T.
Elementary Education/Elementary
Special Education (305) A.A.T.
Secondary Education-Chemistry (306) A.A.T.
Cardiac Rescue (525) Certificate*
Emergency Medical Services (518) A.A.S.
Emergency Medical Services (519) Certificate
Nationally Registered Paramedic (516) Certificate
General College Studies: Allied Health (120) A.A.
Nursing: Registered Nurse (131) A.S.
Phlebotomy (515) LoR*
Physical Therapist Assistant (140) A.A.S.
Radiologic Sciences (502) A.A.S.
Surgical Technology (512) Certificate
Non-Degree Seeking Students*
Hotel/Restaurant Management
A.A.S. Associate of Applied Science
A.A.
Associate of Arts
A.S.
Associate of Science
A.A.T. Associate of Arts in Teaching
Other Award Abbreviation
LoR
Letter of Recognition *
Hotel/Restaurant Management (650) A.A.S.
Food Service Management (655) Certificate
Food Service Management (654) LoR*
Hotel/Resort Management (651) Certificate
Hospitality Management (648) LoR*
Date application entered: _____________________________
FOR OFFICIAL USE ONLY
New Application ______
If updated, last semester attended: ____________________
Updated Application ______
Liberal Arts and Sciences (200) A.A.
African-American Studies (820) LoR*
Biology (311) LoR*
Basic Chemistry (312) LoR*
Communications (313) LoR*
General Science (314) LoR*
Geography (315) LoR*
Mathematics (316) LoR*
Music (803) LoR*
Transfer Studies
Advanced (250) Certificate*
Basic (150) Certificate*
Processed by: _______________________________________________ at (please check one)
___WMC
___ Cambridge Ctr.
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Audit (950)*
Personal enrichment/Professional
development/update job skills (951)
Dual Enrollment Students (960)*
The “960” option is for high school
students who plan to enroll in the Dual
Enrollment Program.)
Key to Degree Award
Abbreviations
___ Center for Allied Health
[7-14]
FOR OFFICIAL USE ONLY
P.O. Box 8, Wye Mills, MD 21679
Web address: www.chesapeake.edu
(410) 822-5400; 758-1537; 228-4360 Fax #: 410-827-5878
TTY Users: Call via Maryland Relay
Date: ________ Semester: _________
Stud. ID #: ______________________
Please print clearly. Use black or blue ink. Check the appropriate boxes and complete entire application. No application fee is
required. Please return completed application to: Chesapeake College, Office of Admissions, P.O. Box 8, Wye Mills, MD 21679.
PERSONAL INFORMATION
Social Security numbers are used by the College to ensure the integrity of
student records and to meet federal government reporting requirements. They
are also needed for Scholarships and Financial Aid.
Social Security
Number:
Last Name (Legal):
First Name:
Other Names (i.e. maiden):
Full Middle Name:
Date of Birth:
(month/day/year)
Current Address
Street Number and Name/Apt. # :______________________________________________________________________________________________ P.O. Box #: __________________________________
City:
How long have you lived at your current address?
State:
Zip Code:
Less than 3 months
3 months or more
If less than 3 months, list previous address:
Street Number and Name/Apt. # :___________________________________________________________________________________ P.O. Box #: __________________________________
City:
Length of time at previous address:
State:
Months:
Zip Code:
Years:
County of Residence:
Phone Numbers:
005 Caroline
017 Queen Anne’s
Other MD County (write below):
009 Dorchester
020 Talbot
___________________________
014 Kent
040 Out-of-State
099 Out-of-Country
Home:
___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Cell:
___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Email:_____________________________________________________________________________________________________________________________________________
I certify that the following information is correct and complete to the best of my knowledge:
I am a dependent of and live with my parent(s) or guardian(s) at the Current Address given above.
I was claimed by my parents in the previous tax year.
Yes
If yes, what is their legal state of residence? _____________________________________
Gender:
Male
Yes
No
No
If Maryland, what county? ______________________________________
Female
How many hours do you spend in a typical 7-day week:
Working for pay:
None
1-5 hours
6-10 hours
Providing care for dependents living with you:
None
11-20 hours
1-5 hours
21-30 hours
6-10 hours
More than 30 hours
11-20 hours
21-30 hours
More than 30 hours
ETHNICITY INFORMATION
The following information is gathered for purposes of meeting state and federal agency requirements. This information is not used for admission to
Chesapeake College.
Part 1: Please select the group which most closely represents you:
Hispanic/Latino (HIS)
Part 2: Please select one or more of the following groups which most closely represents you:
American Indian or Alaska Native (AN)
Asian (AS)
Black or African American (BL)
Native Hawaiian or Other Pacific Islander (HP)
White (WH)
Non-Hispanic/Latino (NHS)
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from
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MILITARY STATUS
Are you a veteran or a dependant (including spouse) of a veteran?
Yes
If yes, check one:
Veteran
Dependant
If you are active duty military, where are you stationed? ________________________________________________________________________ (To be considered for incounty or in-state tuition due to BRAC, you will need to provide your orders to the Registration office at the Wye Mills Campus for verification.)
CITIZENSHIP INFORMATION
CITIZENSHIP
(Please check one option)
U.S. Citizen (US)
Permanent Resident (RA)
(The applicant must present the Permanent Resident Card to the Admissions Office staff at the Wye Mills Campus for
verification prior to college acceptance.) A copy of the Card will be made and included with this admissions application. In the absence of documentation, a
student is charged out-of-state tuition and fees.
Non-U.S. Citizen (NA) (If you checked Non-U.S. Citizen, you must state your country of citizenship here: ___________________________________________)
Are you here on a VISA?
Yes
No
If yes, state type of VISA: ________________________________________________
VISA #: ______________________________________________________________________________________________
To all VISA Holders: You must submit your original documentation to the Admissions Office at the Wye Mills campus for verification prior to college
acceptance.
Country of Citizenship: _______________________________________________________
Do you plan to enroll at Chesapeake College as a visiting student and maintain an F1 status at your home school?
Yes
No
All VISA students must contact the Registrar at Chesapeake College for admission and enrollment information and procedures.
Application deadlines for International Students:
June 1 for the Fall semester
November 1 for the Spring semester
PERSONS TO CONTACT IN CASE OF EMERGENCY
Last Name:
Relationship to you:
First Name:
Parent/Guardian
Spouse
Last Name:
Relationship to you:
Middle Initial:
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Other
First Name:
Parent/Guardian
Spouse
Middle Initial:
Phone Number: ___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Other
FIRST-GENERATION STUDENT INFORMATION
Your parent’s educational level:
▪ Less than high school
▪ Completed high school or GED
▪ Some college, but no degree
▪ Two-year college degree
▪ Four-year college degree
▪ Advanced degree (Graduate or Professional)
▪ Unknown
Semester/Year applied for:
Mother
SEMESTER START STATUS
Fall (Aug.-Dec.)
Are you applying for Financial Aid?
Father
Spring (Jan.-May)
Yes
Summer (June-Aug.)
Year 20__ __
No
Academic Goal
Admission Status: (check one)
(FF) First-time Freshman (never attended a college/university after
Please check the one statement which most closely corresponds to your primary reason for
attending Chesapeake College:
high school)
(HS) High School (attending while still enrolled in high school)
(ND) Non-Degree seeking (taking courses WITHOUT intention
of earning a Chesapeake College degree)
(R3) Returning Student (returning to Chesapeake after absence of
three semesters or longer)
(RT) Returning Student (returning to Chesapeake after absence of
less than three semesters)
(TR) Transfer (transferring from another college to Chesapeake)
1). Exploration of new career or academic area
2). Preparation for immediate entry into a career
3). Preparation for transfer to a four-year institution
4). Preparation for a job I currently hold
5). For interest and self-enrichment
6). Visiting student
(VS) Visiting Student (enrolled at another college and planning to
transfer Chesapeake College coursework back to home institution)
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from
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SECONDARY SCHOOL INFORMATION
From which high school did you graduate or will you graduate?
Year of graduation: ____________
210318 Cambridge-South Dorchester
210994 Kent Island
210469 Wesleyan Christian School
210491 Chesapeake Christian School
210477 North Caroline
219300 Out-of-State High School
210525 Colonel Richardson
210655 North Dorchester
210490 Easton
210364 Queen Anne’s County
219501 Home-Schooled
210496 Sts. Peter & Paul
211095 Kent County
210925 St. Michaels
219100 Other Maryland School
Please list: _____________________
Did you graduate from a local high school CTE (Career and Technology Education) Program?
Yes
No
GED Students: Please complete the following section.
219200 Maryland GED
Year earned: _______________
219400 Out-of-State GED
Year earned: _______________
I am interested in attending Chesapeake College, but have not graduated from a high school nor earned a GED.
(Note: Applicants who checked the box above will not be denied admission to Chesapeake College.)
COLLEGE OR UNIVERSITY ATTENDANCE
I have earned college credit at other colleges or universities since high school graduation.
Yes
If yes, what is the highest degree you have earned?
Master’s
Associate’s
Bachelor’s
No
Doctorate
PRIOR COLLEGES/UNIVERSITIES ATTENDED (Please list all institutions starting with the most recent. Use separate sheet if necessary.)
NAME
CITY AND STATE OR COUNTRY
DATES ATTENDED
DEGREE
________________________________________________________
________________________________________
_______________________
___________
________________________________________________________
________________________________________
_______________________
___________
________________________________________________________
________________________________________
_______________________
___________
BACHELOR’S DEGREE PROGRAMS – EASTERN SHORE HIGHER EDUCATION CENTER
Salisbury University and University of Maryland - University College offer the junior and senior years of the following Bachelor’s Degree Programs at the
Higher Education Center located on the Wye Mills Campus. If you intend to complete your Bachelor’s Degree at the Higher Education Center, please
check the appropriate intended degree program box.
Salisbury University
Social Work
Elementary Education
University of Maryland - University College
Business Administration
Criminal Justice
AREA OF STUDY - PROGRAM/MAJOR CODE
It is important that you complete this section to ensure a correct selection of your College Major Code. Please turn to the back page of
this application and write in your three-digit Program/Major Code. ____ ____ ____
Note: Chesapeake College reserves the right to award students all academic credentials earned, including certificates and degrees.
HONOR CODE FOR CHESAPEAKE COLLEGE
Students of Chesapeake College agree to demonstrate academic and personal integrity. Chesapeake College students are persons of integrity: they stand for that which is right.
They tell the truth and ensure that the full necessary truth is known. They do not lie. * They embrace fairness in all actions. They ensure that work submitted as their own is
their own, and that assistance received from any source is authorized and properly documented. They do not cheat. * They respect the material and mental property of others
and ensure that others are able to benefit from the use of their own property. They do not steal. * Therefore, each student at Chesapeake College pledges to:
♦ Submit assignments that reflect his/her own thoughts and work
♦ Cite and properly acknowledge the thoughts and work of others
♦ Complete all test and other in-class assignments using his/her own thoughts
♦ Reject the use of materials acquired illegally
♦ Respect the rights and property of others
Those found to be in violation of this code agree to disciplinary sanctions and appeal processes outlined within the Chesapeake College Student Code of Conduct.
* Adapted from the U.S. Naval Academy Code of Honor
APPLICANT’S AGREEMENT (Please read carefully and sign)
In making this application, I accept and agree to abide by the policies and regulations of Chesapeake College. I certify that the information on this application is complete and
accurate. Failure to provide accurate information, particularly in the case of residency, may be just cause for dismissal from the college. I understand that it is my responsibility
to notify the Office of Registration of any change in the information contained in this application.
Applicant Signature: _________________________________________________________________________________________________ Date: _______________________________________
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from
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AREA OF STUDY - PROGRAM/MAJOR CODE
Please circle ONE Program/Major Code in the section below and write in your three-digit program in the “AREA OF
STUDY - PROGRAM/MAJOR CODE” section on page 3. Detailed information about programs of study, including course
requirements and course descriptions, can be found in the online College catalog at www.chesapeake.edu.
Any Program/Major marked with an asterisk (*)is not eligible for Financial Aid.
Accounting/Business
Education/Teaching (continued)
Human Services
Accounting (410) A.A.S.
Advanced (412) Certificate
Basic (411) Certificate
Tax (413) LoR*
Business Administration (350) A.A.
Business Management Tech. (401) A.A.S.
Business Management Tech. (402) Certificate
Business Management Tech. (403) LoR*
Secondary Education-English (310) A.A.T.
Secondary Education-Mathematics (307) A.A.T.
Secondary Education-Physics (308) A.A.T.
Teacher Aide (345) Certificate
Mental Health (682) A.A.S.
Substance Abuse/Addiction (683) A.A.S.
Liberal Arts and Sciences
Health, Fitness & Exercise Science
Exercise Science (151) A.A.
Exercise Science (158) Basic Certificate*
Exercise Science (159) Advanced Certificate*
Exercise Science/Allied Health (155) A.A.
Sports Management (160) A.A.
Sports Management (168) Basic Certificate*
Sports Management (169) Advanced Certificate*
Agriculture & Environmental Studies
Landscape Architecture (390) A.S.
Landscape Management (395) A.S.
Computer Studies
Computer Information Security (495) A.A.S.
Computer Information Systems:
Interactive Media/Web Design (474) A.A.S.
Advanced (491) Certificate
Basic (492) Certificate
Interactive Media/Web Design (453) LoR*
Microcomputer Applications Specialist (486) A.A.S.
Advanced (496) Certificate
Basic (497) Certificate
Micro. Applications Specialist (455) LoR*
PC & Network Management (477) A.A.S.
Advanced (478) Certificate
Basic (479) Certificate*
Criminal Justice
Engineering Technology
Drafting and Design (743) A.A.S.
Drafting and Design (742) Certificate
Drafting and Design (745) LoR*
Welding
Advanced (776) Certificate
Basic (775) Certificate
Welding (763) LoR*
Paralegal Professions
Paralegal Studies (620) A.A.S.
Paralegal Studies (622) Certificate
Technical/Professional Studies
Technical/Professional Studies (400) A.A.S.
Environmental Science
Undeclared Majors or Transfer
Certificates (150 and 250)*
Environmental Science (360) A.S.
Environmental Monitoring (364) Certificate
Land Use Management (405) LoR*
(Students in an undeclared major or
transfer certificate are NOT eligible for
financial aid.)
Health Professions
Corrections (604) A.A.S.
Corrections (608) Certificate
Crime Scene Technician (607) A.A.S.
Crime Scene Technician (605) Certificate
Law Enforcement (602) A.A.S.
Law Enforcement (606) Certificate
Education/Teaching
Early Childhood Development (641) A.A.S.
Advanced (642) Certificate
Basic (645) Certificate
Early Childhood Development (643) LoR*
Early Childhood Education/Early
Childhood Special Education (309) A.A.T.
Elementary Education/Elementary
Special Education (305) A.A.T.
Secondary Education-Chemistry (306) A.A.T.
Cardiac Rescue (525) Certificate*
Emergency Medical Services (518) A.A.S.
Emergency Medical Services (519) Certificate
Nationally Registered Paramedic (516) Certificate
General College Studies: Allied Health (120) A.A.
Nursing: Registered Nurse (131) A.S.
Phlebotomy (515) LoR*
Physical Therapist Assistant (140) A.A.S.
Radiologic Sciences (502) A.A.S.
Surgical Technology (512) Certificate
Non-Degree Seeking Students*
Hotel/Restaurant Management
A.A.S. Associate of Applied Science
A.A.
Associate of Arts
A.S.
Associate of Science
A.A.T. Associate of Arts in Teaching
Other Award Abbreviation
LoR
Letter of Recognition *
Hotel/Restaurant Management (650) A.A.S.
Food Service Management (655) Certificate
Food Service Management (654) LoR*
Hotel/Resort Management (651) Certificate
Hospitality Management (648) LoR*
Date application entered: _____________________________
FOR OFFICIAL USE ONLY
New Application ______
If updated, last semester attended: ____________________
Updated Application ______
Liberal Arts and Sciences (200) A.A.
African-American Studies (820) LoR*
Biology (311) LoR*
Basic Chemistry (312) LoR*
Communications (313) LoR*
General Science (314) LoR*
Geography (315) LoR*
Mathematics (316) LoR*
Music (803) LoR*
Transfer Studies
Advanced (250) Certificate*
Basic (150) Certificate*
Processed by: _______________________________________________ at (please check one)
___WMC
___ Cambridge Ctr.
Downloaded
from
http://www.tidyforms.com
Audit (950)*
Personal enrichment/Professional
development/update job skills (951)
Dual Enrollment Students (960)*
The “960” option is for high school
students who plan to enroll in the Dual
Enrollment Program.)
Key to Degree Award
Abbreviations
___ Center for Allied Health
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