Army 101 Application Form

~ Online Application for ARMY 101 ~

This is an application to enroll in ARMY 101 only!
If you decide to enroll in other courses offered at KCTCS, you will be required to reapply and meet all of the minimum college admission requirements.

Items marked with an *asterisk are required fields.

| Back |

* First Name:
Middle Name:
* Last Name:
* Marital Status:
* Social Security Number:	(format: xxx-xx-xxxx)
* Gender:
* Citizenship Status:
* Date of Birth:
* Predominant Ethnic Background:
* Email Address:
Military Status:
Are you a Military Dependent?
Will you be Receiving Veterans Benefits?
Please list any other names that you have used on previous educational records:	(example: maiden name)
Home/Cell Phone Number
* Area Code:
* Number:	(format: xxx-xxxx)
Work Phone Number
Area Code:
Number:	(format: xxx-xxxx)

* Home Mailing Address:
Home Mailing Address:	(optional)
* City:
* State:
* Zip Code:	(5 digits)
* County of Residence:
* Admit Status:
* Are you a former student of ECTC?
* Are you a Resident of Kentucky?

Please select the Continue button below to proceed.