A Collaboration of White Mountains, Lakes Region and Nashua Community Colleges
  • General Information

  • Last four digits of Social Security Number
  • Date Format: MM slash DD slash YYYY
    Date of Birth
  • Employer Information

  • New Hampshire Residence Information

  • To be signed by all applicants

  • The information provided by the applicant on this admission application form shall be held confidential to the extent determined by Federal Law and College policy. The Community College System of New Hampshire reserves the right to deny admission to any applicant who, in the judgement of the college officials, does not qualify for admission. The College also reserves the right to require withdrawal of any student who does not satisfy the ideals of citizenship, character, or scholarship. In accordance with the terms and conditions set forth in its publications, and if accepted to abide by the rules and regulations set forth in the publications and in the Student Handbook, I also agree that the College has permissions to use any College sponsored pictures in which any likeness appears. I certify that I have read and agree with the above, and that all information provided herein is true and complete. For compliance purposes, the Community College System of New Hampshire and its Colleges collects names and social security numbers from all students attending the college. For example, the Internal Revenue Code requires the college to produce a 109-T tax form. The college’s use of social security numbers will be limited to legitimate educational purposes. The college will ensure the security of the student’s social security number and will not disclose it to anyone outside the college, except as authorized by federal or state laws or applicable policies.
  • Date Format: MM slash DD slash YYYY