Application For Admission

I hereby apply for enrollment in Daymar College subject to the provisions of the College’s current catalog. The information on this Application for Admission is accurate, complete and true and any inaccurate, incomplete or false statement will entitle the College to deny admission to me.

To complete a paper copy of this application, click here.

*Fields with a star are required.

Campus Location *


Personal Information
First Name *
Middle Name
Last Name *
Maiden Name
Address *
City *
State *
Zip *
Home Telephone *
Cell Phone
Work Phone
Ext
Primary E-mail Address *
Other E-mail Address
Gender *

Date of Birth *

Drivers License Number
Drivers License State
Emergency Contact Name *
Phone Number *
Relation to Applicant *
Emergency Contact Address *
City *
State *
Zip *

Responses to the following questions are voluntary and are used for state reporting purposes only.
Veteran * Yes No
Disabled * Yes No
Citizen * Yes No
If no, Alien No.
Marital Status
Race
Other Race

Transportation Information
Select all that apply
(hold ctrl to select more than one)
Other Transportation

Academic Information
Program of Interest *
Class Time Preference *
Highest Level of
Previous Education *

Name of High School Attended
Address
City
State
Zip
Date of Graduation
Date of GED Test
Testing Center

Name of Previous College
Address
City
State
Zip
Name of Previous College
Address
City
State
Zip
Admission to, employment by and promotion at Daymar College shall be on the basis of merit, and there shall be no discrimination on the basis of race, color, creed, sex, handicap, or national origin. Daymar College provides equal opportunity to all persons.
Applicants Initials *

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All Fields Required
Campus Location
Program of Interest
First Name
Last Name
Address
City
State
Zip
Day Phone
Email


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