Last Name

First

Address

City 

State Ohio Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam 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 Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Phone Number   (740/389-1212)  

Email address 

Social Security No. (121-12-1212)

Have you attended MTC under another name? No Yes If yes, give that name:   

Second Chance Grant Application

Are you a resident of the State of Ohio?   Select: Select Yes or No Yes No

Have you obtained an Associate degree (or higher) from any accredited institution of higher education?   Select: Select Yes or No Yes No

Have you “stopped out” from a state institution of higher education in Ohio and did not transfer to another institution of higher education in the two semesters immediately following the disenrollment? Select: Select Yes or No Yes No

Were you in good academic standing with no record of disciplinary issues (including suspension or expulsion) at the time of disenrollment? Select: Select Yes or No Yes No

Are you re-enrolling in a qualifying institution within five years of disenrollment? Select: Select Yes or No Yes No

Are you starting your re-enrollment on or after January 1, 2022? Select: Select Yes or No Yes No

Are you currently enrolled in the College Credit Plus program? Select: Select Yes or No Yes No

Have you completed the Free Application for Federal Student Aid (FAFSA)?  Select: Select Yes or No Yes No

Are you pursuing a credential or degree beyond that which they already possess (i.e., if the student possesses an associate degree, the student is pursuing a bachelor’s degree)? Select: Select Yes or No Yes No

Are you a recipient of one of the following state supported scholarships: Choose Ohio First Scholarship, Ohio Safety Officers College Memorial Fund, War Orphans and Severely Disabled Veterans’ Scholarship Program, or Ohio National Guard Scholarship? Select: Select Yes or No Yes No

By checking this box, I hereby release my photo and information to be used in any way to promote the college, scholarships and the Marion Technical College Foundation.

I certify that the information which I have provided is correct. Furthermore, I certify that I am not in default on any Title IV loan made for attendance at any institution and do not owe a refund on any Title IV grant received for attendance at any institution. If I am applying for a scholarship, I give my permission for the Financial Aid Office to review my academic record.

Signature:    Date: 00/00/0000

Marion Technical College provides equal opportunities regardless of race, color, national origin, sex, disability, age,  military status, or sexual orientation.