Admissions

Apply for Admission

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Application for Admission

Section 1: Candidate Information
Page 1 of 5
Social Security Number

Required if applying for Federal Financial Aid.

1. 
Social Security Number:    
Format: 123-45-6789
Personal Information
2. 
Legal First Name
*Required, Maximum characters allowed: 30
3. 
Middle Name
Maximum characters allowed: 30
4. 
Legal Last Name
*Required, Maximum characters allowed: 60
5. 
Suffix
6. 
Maiden Name
Maximum characters allowed: 30
7. 
Email Address
*Required, Format: x@x.xx
8. 
Cell Phone Number
Format: 123-456-7890
Additional Biographic Information
The reporting of additional biographic information does not affect your admission to Mesalands Community College.
9. 
If you are a legal resident of New Mexico, have you resided in the state for the past twelve consecutive months?
10. 
Date of Birth       
*Required, Format: mm/dd/yyyy
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11. 
Are you a first generation student?
*Required
12. 
Gender
13. 
Tribal Agency
14. 
Citizenship Status
15. 
Citizenship
16. 
Ethnicity
17. 
Race
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