SCIT Application for Admissions
Please complete the below application (2 pages) to seek admission to SCITs campus based programs. If you have any questions about the application, then please feel free to contact the Admissions Department by calling (714) 300-0300 (Mon-Fri, 10am-5pm PST, except holidays) or emailing admissions@scitech.edu. We look forward to welcoming you to our SCIT community!
General Information
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Date of Birth
*
/
Month
/
Day
Year
Date
Email
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Ethnicity
*
White
Hispanic/Latino
Black
Asian
Native American
Pacific Islander
2 or More
Other
Marital Status
*
Single
Married
Gender
*
Male
Female
What is your legal residency status?
*
US Citizen
Permanent Resident
Other
Have you graduated from high school?
*
Yes
No
If NO, do you have a G.E.D.?
*
Yes
No
Have you served in the US Military?
*
Yes
No
If YES, what is your discharge date?
*
/
Month
/
Day
Year
Date
Have you ever been convicted of a felony?
Yes
No
If YES, when?
Approximate year(s)
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Educational History
High School and College Information
High School
College 1
College 2
Name
City
State
From (Year)
To (Year)
Did you graduate from the high school listed above?
*
Yes
No
I did not attend high school
If YES, what year did you graduate high school?
*
Did you graduate from College 1 listed above (if listed)?
Yes
No
If YES, what degree did you earn from College 1?
Did you graduate from College 2 listed above (if listed)?
Yes
No
If YES, what degree did you earn from College 2?
Employment Information
Are you currently employed?
*
Yes
No
If YES, what is your current employer's name?
*
If YES, what is your current position title?
*
Emergency Contact
Name of person to contact in case of emergency
First Name
Last Name
Relation of person to you
E.g. Mom, Dad, Brother, Sister, Friend, etc.
Phone number of emergency contact
Please enter a valid phone number.
Certification
I certify these responses are true and correct to the best of my knowledge. I understand any knowing falsification or failure to provide complete information may result in denial of admission to Southern California Institute of Technology or dismissal after admission.
Signature
Signature Date
*
/
Month
/
Day
Year
Date
How did you first hear about us?
E.g. Google search, Facebook, Referred by Friend/Employer, etc.
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