Forms - Northwest Florida State College

OKALOOSA-WALTON COLLEGE100 College Boulevard • Niceville, Florida 32578BACHELOR OF APPLIED SCIENCE IN PROJECT AND ACQUISITIONS MANAGEMENT(BAS DEGREE)BACCALAUREATE SUPPLEMENTAL APPLICATION FORMSTUDENT INFORMATION (Please Print in Ink):SOCIAL SECURITY NUMBER:LAST NAME FIRST NAME MIDDLE NAME MAIDEN NAMEMAILING ADDRESS CITY STATE ZIP( ) ( ) ( )HOME PHONE NUMBER WORK PHONE NUMBER EVENING PHONE NUMBER PRIMARY E-MAIL ADDRESSWHEN DO YOU PLAN TO ENTER THE BACCALAUREATE PROGRAM AT OWC? FALL (August)Year _________ SPRING (January) Year _________ SUMMER (May/June) Year _________HAVE YOU PREVIOUSLY ATTENDED OWC? YES If Yes, specify last term attended ______________________________________ NO If No, complete an OWC Admission & Residency Form in addition to this form.SELECT AN AREA OF SPECIALIZATION: Acquisitions Quality Improvement Undecided Public Service Management Training & Development/Human Resources Project Management Customized ProgramPREVIOUS POSTSECONDARY EDUCATION:List all colleges, universities, technical schools, etc. you have attended since high school. Official Transcripts must be requested andsent directly to OWC’s Office of Enrollment Services from all institutions listed including official score reports from CLEP, DANTES, AP or IB.NAME OF INSTITUTION CITY/STATE DATES OF ATTENDANCE DEGREESEARNEDI certify that the information given in this application is complete and accurate, and I understand that to make false or fraudulent statementswithin this application or residence affidavit may result in disciplinary action, denial of admission, and invalidation of credits ordegrees earned. If admitted, I hereby agree to abide by the policies of the Board of Trustees and rules and regulations of the College.I hereby authorize OWC to obtain student records electronically from any Florida school or college previously attended or any collegeplacement test scores. I further agree to allow all my records to be electronically transferred to the institution of my choice. I certify thatas a condition of my admission, I will not engage in the unlawful manufacture, distribution, dispensation, possession, or use of acontrolled substance during enrollment at OWC.Applicant SignatureDateAn Equal Access/Equal Opportunity Institution May 2006