*****Must fill in all fields or the form will not submit*****
Name:
First Name:
Middle Name:
Last Name:
Former Name:
Street Address:
City:
State: OH AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OK OR PW PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY
Zip code:
County: --------------------- non-Ohio 01 ADAMS 02 ALLEN 03 ASHLAND 04 ASHTABULA 05 ATHENS 06 AUGLAIZE 07 BELMONT 08 BROWN 09 BUTLER 10 CARROLL 11 CHAMPAIGN 12 CLARK 13 CLERMONT 14 CLINTON 15 COLUMBIANA 16 COSHOCTON 17 CRAWFORD 18 CUYAHOGA 19 DARKE 20 DEFIANCE 21 DELAWARE 22 ERIE 23 FAIRFIELD 24 FAYETTE 25 FRANKLIN 26 FULTON 27 GALLIA 28 GEAUGA 29 GREENE 30 GUERNSEY 31 HAMILTON 32 HANCOCK 33 HARDIN 34 HARRISON 35 HENRY 36 HIGHLAND 37 HOCKING 38 HOLMES 39 HURON 40 JACKSON 41 JEFFERSON 42 KNOX 43 LAKE 44 LAWRENCE 45 LICKING 46 LOGAN 47 LORAIN 48 LUCAS 49 MADISON 50 MAHONING 51 MARION 52 MEDINA 53 MEIGS 54 MERCER 55 MIAMI 56 MONROE 57 MONTGOMERY 58 MORGAN 59 MORROW 60 MUSKINGUM 61 NOBLE 62 OTTAWA 63 PAULDING 64 PERRY 65 PICKAWAY 66 PIKE 67 PORTAGE 68 PREBLE 69 PUTNAM 70 RICHLAND 71 ROSS 72 SANDUSKY 73 SCIOTO 74 SENECA 75 SHELBY 76 STARK 77 SUMMIT 78 TRUMBULL 79 TUSCARAWAS 80 UNION 81 VAN WERT 82 VINTON 83 WARREN 84 WASHINGTON 85 WAYNE 86 WILLIAMS 87 WOOD 88 WYANDOT If you live out of state please select non-Ohio as your county.
Non-MTC Email Address: or Home Number:
Cell Number: or Home Number:
Birth Date:
SSN/ or Gov't ID:
Legal Gender: Male or Female
Check here if you are you now or have you ever been a member of the armed forces of the United States? Yes or No
Check here if you are the spouse or a dependent of someone who is or has been a member of the armed forces of the United States. Yes or No
** MUST MAKE A SELECTION OR FORM WILL RETURN AN ERROR
(Please check the box next to your area of study.)
Once you meet with your advisor you will be able to register for courses and update your program of study. Someone from your intended area of study will contact you to schedule an appointment.
If you would like to be considered for any need-based financial aid, you must file your FAFSA at www.fafsa.ed.gov. If you were not in good academic standing when you left MTC, you may need to appeal to receive your funds upoin your return. Please check with Financial Aid Office to determin if any additional documents are needed.
What year did you last attend Marion Technical College?
Check here if you were enrolled in an off-campus program.
If you were which off-campus program were you enrolled in?
College Credit Plus
MCI/NCCI/NCCC
Whirlpool
Vaughn Industries
Other