Dual Enrollment Application

We'd like to get to know you

First Name

Middle Name

Last Name

Suffix

Preferred First Name

What is your birth/maiden name?

Date of Birth

Gender

Personal Email Address

Confirm Personal Email Address

Alternate Email Address

Cell Phone Number

Alternate Phone Number

How do you prefer to be contacted?

Are you a U.S. Citizen?

Social Security Number

Please select one

Country of Citizenship

If you are here on a visa, what type of visa is it?

Address

City

State

If your Country of Citizenship is not United States, please select FA as your State

Zip Code

Parent/Guardian Information

Parent/Guardian's First and Last Name

Relationship to you

Address

City

State

If your Country of Citizenship is not United States, please select FA as your State

Zip Code

Primary Phone Number

Email Address

Employer

Work Phone Number

How much education did your most educated parent or guardian complete?

Military Status

Have you been or are you affiliated with the military?

U.S. Military Status

Military Branch/Organization

National Guard Location

Are you interested in learning more about the National Guard GOLD program as a way of paying for college?

Military Branch/Organization

Are you receiving military benefits?

Which benefits do you receive?

VADoDMilitary State Benefits Program

Please select the VA benefits you receive

Please select the DoD benefits you receive

Please select the Military State Benefits you receive

Service Begin Date

Service End Date

Are you a dependent of a veteran/active duty military member?

Military Branch/Organization

Racial/Ethnic Background (optional)

Do you consider yourself to be Hispanic/Latino?

Select one or more of the following races:

Other

Religious Affiliation (optional)

Is your father/mother an employee of our school?

Father/Mother's First Name

Father/Mother's Last Name

How did you hear about William Woods?

Enrollment Information

Most Recent Enrollment Information

What high school do you currently attend or most recently attend? Choose Unknown High School if no match exists for high school

Unknown High School

If you selected Unknown High School, please type in the school's name

If you selected Unknown High School, please type in the school's location

What year will you graduate?

High School Counselor Name

High School Counselor Email

Enrollment Status

Do you intend to take classes online or on campus?

When do you intend to begin classes?

When do you intend to begin taking classes?

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