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COUNTY COMMUNITY COLLEGEAPPLICATION FOR ADMISSIONCentral Admissions533 College RoadSelden, New York 11784(631) 451- 4000Ammerman CampusAdmissions Office533 College RoadSelden, New York 11784(631) 451- 4022Eastern CampusAdmissions Office121 Speonk-Riverhead RoadRiverhead, New York 11901(631) 548 -2512Michael J. Grant CampusAdmissions OfficeCrooked Hill RoadBrentwood, New York 11717(631) 851- 6718sunysuffolk.eduSuffolk County Community College promotes intellectual discovery, physical development, social and ethical awareness,and economic opportunities for all through an education that transforms lives, builds communities, and improves society.2016
DIRECTIONS FOR ADMISSIONS APPLICATIONApplyComplete all sections of the application as indicated; be sure to sign and date the application.PayComplete the Application Fee Processing Form. Include a check or money order for the 40 application fee payable to:Suffolk County Community College. DO NOT SEND CASH.SubmitHigh SchoolTranscriptRequest and submit your official high school transcript(s). If you have earned a high school equivalency diploma,attach a copy of the diploma and scores with your completed application.Applicants with a high school diploma from outside the United States must submit an Educational CredentialEvaluation from an accredited agency as listed on the College’s website at sunysuffolk.edu/Procedures.If you received an Individualized Education Program (I.E.P.) Diploma or a CDOS Commencement Credential, were home schooled,or earned your high school diploma online, please contact the Admissions Office. See contact information on front cover.SubmitCollegeTranscriptIf you have college credits you wish to transfer, request and submit official college transcript(s) from each institution attendedincluding college courses taken in high school.Applicants who attended college outside the United States who wish to transfer credits must submit a course-by-course evaluationof your transcript from an accredited agency as listed on the College’s website at sunysuffolk.edu/Transfer-In.Active Military/Veterans – submit your official Joint Services Transcript (JST) for evaluation for college credit.Submit ScoreReportsRequest and submit official ACT or SAT scores, if available. Submit official Advanced Placement score report(s) andInternational Baccalaureate exam results.NotesAll documents must be submitted to:Suffolk County Community College, Central Admissions, 533 College Road, Selden, NY 11784For more information, visit us at sunysuffolk.edu.1. Your application will not be processed until SCCC receives your high school transcript or high school equivalency diploma, orofficial college transcript showing degree earned.2. Please review the online college catalog for special admissions criteria and filing deadlines for certain restricted programs atsunysuffolk.edu/Programs.SUPPLEMENTAL INFORMATIONJOINT ADMISSIONSIf you are interested in transferring to a four-year college upon graduation from Suffolk, then Joint Admissions may be of interest to you. Uponcompletion of your associate degree, you can transfer to one of the participating colleges providing you meet the requirements of the joint admissionsagreement. This guaranteed admission to the four-year college will be honored for a two-year period following graduation from Suffolk, providing youdo not matriculate at another institution. Note that you are under no obligation to attend the four-year college should your plans change forany reason.To apply for joint admissions, refer to the list of participating colleges on sunysuffolk.edu/TransferOpps. You should also consult the catalogs from bothSuffolk and the four-year college prior to admission. During your first semester at Suffolk, it is recommended that you speak with a counselor regardingyour joint admissions plans.Suffolk may share enrolled student information with colleges with which it has joint admissions or articulation agreements.HONORS PROGRAMEDUCATIONAL OPPORTUNITY PROGRAM (EOP)The Honors Program is a college-wide interdisciplinary programfor academically talented and highly motivated students. It isgrounded in the traditions of the liberal arts and stresses theconnections among various disciplines and the tools of artistic,scientific, and intellectual creativity.The Educational Opportunity Program (EOP) is designed to provide academicsupport to students enrolled full-time in a curriculum at thecollege. Students admitted to the program have the academic potentialto attain a college degree, but may need additional academic support andcounseling throughout their time at the college to persist to graduation.The Honors Program combines small classes, gifted faculty,enthusiastic students, rigorous course work, and variousactivities to create an environment that nurtures intellectualgrowth. Honors classes are offered during the day and eveningand are available to both part-time and full-time students on allthree campuses. For requirements and to access the onlineHonors Program application, visit sunysuffolk.edu/Honors.EligibilityThe program is offered to full-time students who are New York State residents fortwelve months prior to attending college. EOP accepts students who qualifyacademically and financially based on the following guidelines:a. New York State residentb. recipient of a high school diploma or its equivalentc. full-time registrationd. high school average of 83 or less in major subjects, or placement in oneor more developmental coursese. non-high school graduate who is admitted to SCCC through the Abilityto Benefit (ATB) programf. meet NYS legislated incomeThe Personal Privacy Protection Law requires this notice to be provided when collecting personal information from individuals. The information on this Admissions Application will be used by SCCC to evaluate your request foradmission. Failure to provide the requested information could prevent your application from being processed. The authority to request this information is found in Section 355 (2) (i) of the Education Law. This applicationinformation will be maintained in the College Records Office. The official responsible for the maintenance of this information is the College Registrar, Suffolk County Community College, 533 College Road, Selden, NY 11784.It is the policy of Suffolk County Community College not to discriminate in admissions on the basis of race, color, religion, sex, age, marital status, sexual orientation, national origin or handicap, except as such conditions mayconstitute bona fide occupational or assignment qualifications in nursing and health careers courses and the departmental health requirements.All campus crime statistics are available on the College website at sunysuffolk.edu/Safety.1
PROGRAMS OF STUDYDEGREE CAMPUS CODEDEGREE CAMPUS CODEAALiberal Arts and Sciences: Adolescence Education* A E GAASAccounting (Career Option)A E GACCT-AASBiology Option (leading to a B.A.)A E GAEBA-AAASAccounting (Transfer Option)A E GACCT-ASBiology Option (leading to a B.S.)A E GAEBE-AACertAccountingA E GACCT-CERTEnglish Option (leading to a B.A.)A E GAEEE-AAAASAmerican Sign Language StudiesAASL-SD-AASAEHE AAAASAutomotive Service Specialist: History Option (Social Studies leading to a B.A.) A E GMathematics Option (leading to a B.A.)A E GAEMA-AAGeneral Motors Option lAAUTO-AASMathematics Option (leading to a B.S.)A E GAEME-AAGeneric Option lAAUTO-AASLiberal Arts and Sciences: Education (Child Study)* A E GEDCS-AAHonda Option lAAUTO-AASAALiberal Arts and Sciences: General StudiesA E GLAGS-AAAASToyota T-TEN Automotive ServiceATOYT-AASAALiberal Arts and Sciences: HumanitiesAASBusiness Administration (Online Option)A E GBUAO-AASCinema Studies OptionALACS-AAAASBusiness Administration (Career Option)A E GBUAD-AASCreative Writing OptionALACW-AAASBusiness Administration (Transfer Option)A E GBUAS-ASEnglish OptionALAEG-AACertBusiness ManagementA E GBUMG-CERTForeign Language OptionALAFL-AAAASBusiness: MarketingGBUMK-AASPhilosophy OptionALAPL-AAAASBusiness: Retail Business ManagementABURM-AASLAIS-AAAALiberal Arts and Sciences: International StudiesA E GCertBusiness: Retail Business ManagementABURM-CERTAALiberal Arts and Sciences: MathematicsALAMA-AAAASChemical Dependency Counseling (Day)GCHDPD-AASASLiberal Arts and Sciences: ScienceAASChemical Dependency Counseling (Evening)GCHDPE-AASBiology OptionA E GLABI-ASAACommunication StudiesA E GCOST-AAChemistry OptionALASC-ASAACommunications and Media Arts: JournalismACOMA-AAEarth and Space Science/Astronomy OptionALAAS-ASEAASComputer Art lCOAR-AASEarth and Space Science/Geology OptionALAGE-ASASComputer ScienceACOSC-ASEarth and Space Science/Meteorology OptionALAME-ASAASConstruction Technology-Architectural Technology ACTAT-AASEnvironmental Science/Forestry OptionA E GLAFR-ASASCriminal JusticeA E GCRJU-ASPhysics OptionALAPH-ASAASCulinary Arts: Baking and Pastry ArtsECUBP-AASAALiberal Arts and Sciences: Social ScienceCertCulinary Arts: Baking and Pastry ArtsECUBP-CERTHistory OptionAGLASH-AAAASCulinary Arts: Restaurant ManagementECURM-AASPolitical Science OptionAGLASS-AACertCulinary Arts: Restaurant ManagementECURM-CERTPsychology OptionAGLASP-AAAASDietetic Technician (Day) lEDIET-AASSociology OptionAGLASA-AACertDrafting (Computer-Assisted)ADRFT-CERTAALiberal Arts and Sciences:Women’s and Gender Studies ALAWS-AAAASEarly Childhood (Career Option)A E GEACH-AASAASManufacturing Technology lGMFTY-AASASEarly Childhood (Transfer Option)A E GECAS-ASMusicAMUSC-ASASAASElectrical Technology - ElectronicsAELTC-AASASNursing (Day) (Fall Start) lANURN1-ASAASEmergency Medical Technician: ParamedicAPARM-AASASNursing from LPN (Day) (Spring Start)ANURN2-ASASEngineering ScienceAENSC-ASASNursing (Day) (Fall Start) lGNURN4-ASAASFire Protection TechnologyAFRPT-AASASNursing from LPN Day (Fall Start) lGNURN5-ASCertFire Protection TechnologyAFRPT-CERTASNursing (Evening) (Fall Start) lANURN3-ASASFitness SpecialistAFTSP-ASASNursing (Evening) (Spring Start)GNURN6-ASAASGraphic Design lEGRDS-AASAASOccupational Therapy Assistant (Day) lGOCTA-AASAASHealth Information Technology/AASParalegal StudiesAPALG-AASGGMedical Records (Evening) lHEIT-AASCertParalegal StudiesAGPALG-CERTGHVAC-AASAASHeating, Ventilation, Air Conditioning and Refrigeration lAASPhotographic Imaging lEGPHOT-AASGCertHeating, Ventilation, Air Conditioning and Refrigeration lHVAC-CERTAASPhysical Therapist Assistant lAPHTA-AASAASHotel and Resort ManagementEHRMN-AASPractical Nursing (LPN) (Day)ENUPN-CERTCertHotel and Resort ManagementEHRMN-CERT CertAASRadio and Television Production lARATV-AASASHuman Services (Preparation for Social Work)AHUSR-ASTheatre ArtsAASInformation Technology: ASActing OptionATHAC-ASComputer Information SystemsA E GITIS-AASGeneral Theatre OptionATHGT-ASNetwork Design and AdministrationA E GITND-AASTechnical Theatre OptionATHTT-ASCertInformation Technology:AASVeterinary Science Technology lGVETSD-AASComputer Information SystemsA E GITIS-CERTASVisual ArtsAGVART-ASNetwork Design and AdministrationA E GITND-CERTINDA-AASAASInterior Design lEl Curriculum begins in September only.Campus Codes: A Ammerman Campus at Selden E Eastern Campus at Riverhead G Michael J. Grant Campus at Brentwood* Jointly registered with St. Joseph’s College, Patchogue, NY.2
APPLICATION FOR ADMISSIONPlease Use Black or Blue InkA. BACKGROUND INFORMATION:1. Social Security number*: - -2. Name:(First)(Middle)(Last)3. Other name(s) on your academic credentials:4. Mailing address:(City)(State)(ZIP code)(Number and Street or P.O. Box #)Legal address:(If different from above)(Number and Street)(City)5. Telephone:(State)Required Cell(ZIP code)Home (( ) - -(Country if not USA)) - -Email (Required)6. Date of birth:Month DayYear7. Gender:q Maleq FemalePlease complete this section for local, state and federal reports. Your response does not affect your admission.8a. Are you Hispanic/Latino?q Yesq No8b. If Hispanic or Latino, please indicate your ethnicity (select one):q Cubanq Dominicanq Mexicanq Puerto Ricanq South Americanq Central Americanq Other Hispanic/Latino8c. All applicants, please indicate your race (select one or more):q American Indian or Alaska Native q Asian q Black or African American q Native Hawaiian or Other Pacific Islander q White9. Military affiliation:q Currently serving in the U.S. Armed Forcesq Veteran of U.S. Armed Forcesq Spouse or Dependent of U.S. Armed Forces planning to use VA Education BenefitsB. PREVIOUS EDUCATION:1.Name of High School: City: State:Graduation date or expected date of graduation (mo./year): or Withdrawal date (mo./year):2.3.4.If you have a High School Equivalencey diploma, indicate date issued (mo./year):Were you Home Schooled?q Yesq NoIf you received an Individualized Education Program (I.E.P.) Diploma or a CDOS Commencement Credential, were home schooled, or earned your highschool diploma online, please contact the Admissions Office about applying for the Ability to Benefit Program.List all prior colleges and universities attended:Name of College/UniversityDates of attendanceDate of Graduation (mo./year)Name of College/UniversityDates of attendanceDate of Graduation (mo./year)C. COLLEGE PLANS:Refer to the attached list of Programs of Study; take note of any special admission requirements and campus.q FALL (August/September) 20 (or) q SPRING (January) 201.Semester and year applying for:2.Campus:3.Program of Study: Code:q Ammerman (Selden)q Eastern (Riverhead)q Michael J. Grant (Brentwood)(For nursing applicants only) Second Choice Nursing Program Code:4.Are you applying for Joint Admissions? If yes, indicate your college choice:*Your Social Security Number is used to coordinate the collection of information for all your student records. Authority to collect the Social Security Number is granted underSection 355 of the New York Education Law.3
D. EDUCATIONAL INTERESTS:1.q Scholarshipsq Honors Programq Financial Aidq Intercollegiate Athleticsq Educational Opportunity Program (EOP)q Student Leadershipq On-Campus ChildcareI am interested in the following areas:q Study Abroad2.q Check here if you would like information regarding services for students with a disability.3.q Check here if your native language is not English and you are interested in the English as a Second Language program.E. CITIZENSHIP/IMMIGRATION STATUS:1. Are you a citizen of the United States?q Yesq NoIf you answered “yes,” proceed to Section F (Residency).If you answered “no,” what is your country of citizenship? (Proceed to question 2)2.If not a U.S. Citizen, what is your current immigration status?q Non-citizen legal permanent resident (Attach a copy of both sides of your permanent resident card)q Visa Type of Visa: F or M (student)J (exchange visitor)Other (Attach a copy of your current visa and your Form I-94)3. Do you wish to apply for an International F-1Student Visa? q Yes q No If yes, review the International Admissions page atsunysuffolk.edu/International for the international admissions application requirements.NOTE: If you do not hold lawful immigration status, and you attended a NYS high school for 2 years and graduated or earned a NYS GED withinthe past 5 years, you can submit the Student Affidavit of Intent to Legalize Immigration Status which will be mailed to you.F. RESIDENCY:1. Have you been a legal resident of the State of New York for the past twelve (12) months?2. Have you been a resident of Suffolk County for the past six (6) months?q Yes q Noq Yes q NoNOTE: If you are a NYS resident but have not resided in Suffolk County for six months, contact the County Clerk’s Office in your county ofresidence for a Certificate of Residence form or download the form on our website at sunysuffolk.edu/Out-of-County.All applicants MUST answer questions 1 and 2.1. Have you ever been convicted of a felony? (required)q Yes q No2. Have you ever been suspended, dismissed or expelled from a college or university for disciplinary reasons? (required)q Yes q Noq I declare that all information on this application is true to the best of my knowledge.q I am enclosing the 40 application fee which I understand is non-refundable.(Signature - required)*(Date)Note: It is your responsibility to send official college transcripts (including those for college coursestaken in high school), Advanced Placement score reports, International Baccalaureate exam results, and aforeign educational credential evaluation if transferring college credits from outside the United States,to Suffolk County Community College, Central Admissions, 533 College Road, Selden, NY 11784.* By virtue of this signature, I authorize the release of my final official high school transcript(s) by my previous institution(s) in the event that I decide to enroll atSuffolk County Community College as a matriculating student.4
ENROLLMENT CHECKLISTq 1. APPLY FOR FINANCIAL AID:Online filing is available at FAFSA.ed.gov. You can obtain further information atsunysuffolk.edu/FinancialAid.q 2. SUBMIT YOUR IMMUNIZATION RECORDS:If your immunization records were not submitted with your application, you will need toprovide documentation for two measles, mumps, and rubella (MMR) immunizations. Inaddition, you will need to complete the Meningitis form.q 3. AFFIDAVIT OF RESIDENCY:If you are a New York State resident but have not resided in Suffolk County for six months,contact your County Clerk’s Office for a Certificate of Residence form. Forms are available atour Campus Business Offices or you can download the form at sunysuffolk.edu/Out-of-County.q 4. OBTAIN A STUDENT ID CARD:After you have paid your tuition and fees, you will need to obtain a student ID card. Thecard must be carried with you at all times when you are on campus. Visit the public safetysection of the College website for information on obtaining your student ID card.q 5. ATTEND STUDENT ORIENTATION:Students and their parents are invited to new student orientation shortly before the beginningof the College semester. All students are encouraged to attend and become involved in thelife of the campus through campus clubs and activities.!SUFFOLK COUNTY COMMUNITY COLLEGEAPPLICATION FEE PROCESSING FORM - Please Enclose Application Fee ( 40)Be sure to include applicant’s name and Social Security number on check or money orderAPPLICANT’S NAME - PLEASE PRINTPRINT CURRENT ADDRESSSOCIAL SECURITY NUMBER*STATEZIP*Your Social Security number is used to coordinate the collection of information for all your student records. Authority to collect the Social Security number is granted under Section 355 of theNew York Education Law.5
COUNTY COMMUNITY COLLEGE Central Admissions 533 College Road Selden, New York 11784 (631) 451-4000 Ammerman Campus Admissions Office 533 College Road Selden, New York 11784 (631) 451-4022 Eastern Campus Admissions Office 121 Speonk-Riverhead Road Riverhead, New York 11901 (631) 548-2512 Michael J. Grant Campus Admissions Office Crooked Hill Road
