First Name

Middle Name

Last Name

Suffix

Preferred Name

Birth/Maiden Name

Date of Birth

Gender

Birth Country

Birth State

What is your mobile/cell phone number?

Social Security Number

Email

Have you ever been convicted of a felony?

Please explain the circumstances of your felony conviction.

Marital Status

Ethnicity

Race

Permanent Address

Permanent Address City

State or other principal subdivision

Permanent County

Permanent Zip Code

Permanent Address Country

Home Phone

Emergency Contact Info

First Name

Last Name

Phone

Email

Street Address

City

State

Zip Code

Is your father/mother an alumnus of our school?

Is your father/mother an employee of our school?

What is the highest level of education that your father received?

What is the highest level of education that your mother received?

Are you home schooled?

What state is your High School in?

High School City

What's the name of your High School?

What is your anticipated graduation date?

Have you attended any previous colleges or universities?

Where were the colleges you attended?

Are you on academic probation or academic suspension at any other college?

Please explain the circumstances around your probation at the other school.

Previous College/University information:

College/University Country

College/University State

College/University City

College/University Name

College/University Org Code

Additional Names on Transcripts

Anticipated Academic Enroll Year

Anticipated Enrollment Term

Major

Collection Statement

I understand that if I fail to pay any debt to Kilgore College and the debt is sent for collection, I must pay all costs of collection, including attorneys' fees and collection agency fees.

Temporary Student

Are you a temporary student enrolling for Christmas Mini only, or May Mini only, or summer only?

KC Email

Kilgore College assigns all new applicants a KC specific email account.  Once the applicant's admissions application is processed, KC will provide this email account and additional directions for its use.  The email account will serve as the primary and official mode of communication between KC and the student.  It is the responsibility of each KC student to check this email account on a regular basis.

Text Messaging

Kilgore College uses two distinct text messaging systems to communicate with applicants and students. One system, RAVE Alert, sends emergency messages to enrolled students. The other, Remind, sends important reminders, campus updates, and other information. By supplying your cell phone number and submitting this application, you will be enrolled into both of these messaging systems. You may opt-out of one or both by responding to any KC text message with the word STOP.