Dual Credit @ MVC

MVC Dual Credit Application

Personal Info
                <%-- this is the last name section --%>
                Last Name*
                
                        <%-- *** the last name validator/section ending here ********* --%>
            
                <%-- this contains a regularexpression validator --%>
                First Name*
                
                        <%-- *** the first name validator/section ending here ********* --%>
            
                <%-- this contains a regularexpression validator --%>
                Middle Name
                
              <%-- *** the middle name validator section ending here ********* --%>
            
                Birthdate* (mm/dd/yyyy)
                
                <%-- this contains a regularexpression validator --%>
                Primary Email*
                
              <%-- *** the email validator section ending here ********* --%>
            
            Select Your High School* <%--This drop down has the datavluefield and the datatext from SQL for binding --%>
             
             <%--************************************************************************ --%>
        
                Gender* <%--This drop down has the datavluefield and the datatext from SQL for binding --%>
                
                <%--************************************************************************ --%>
            
                US Citizenship Status*<%--This drop down has the datavluefield and the datatext from SQL for binding Marital --%>
                 
                <%--************************************************************************ --%>
            
                <%-- this contains the update pannel needed for the updating of the web page without post back on US Citizenship to display SSN --%>
                
              <%-- *** the SSN validator ends here ********* --%>

<%-----------------------------Address--------------------------------------- this will contain the primary address functionality as well as some cs checks ---------------------------------------------------------------------------- --%>

Primary Address

Address Line 1*

Address Line 2

City*

State*<%--This drop down has the datavluefield and the datatext from SQL for binding Marital --%> <%--************************************************************************ --%>

Missouri County* <%-- This is the drop down for Missouri County ****************** --%> <%-- **************************************************************************** --%>

Zip Code*

<%-- this the phone number and validation (cs attached) --%> Phone Number* <%-- **********************************************************************************************8 --%>

<%-----------------------------Emergency Contact--------------------------------------- ---------------------------------------------------------------------------- --%>

Guardian Information
                Guardian's Last Name*
                
                Guardian's First Name*
                
                Address Line 1*
                
                Address Line 2
                
                City*
                
                State*
                
                Zip Code*
                
                Phone Number*
                
                <%-- this contains a regularexpression validator --%>
                Primary Email
                
              <%-- *** the email validator section ending here ********* --%>
            
                    Guardian Agreement
                
                    This portion of this online form is to be completed by your legal Guardian:
                    I Understand my child/dependent has applied for participating in course work in
                        order to receive college credit at the price of $80.00 per credit hour including
                        any other applicable fees. I consent to the sharing of my student's academic and
                        financial records with school officials and acknowledge that I am responsible for
                        payment to his/her account. I agree to the terms and conditions of policies and
                        procedures set forth by Missouri Valley College.
                    
                    Completing the following section is required by the Guardian and will act as his/her
                        legal signature, agreeing to the statement above
                    
                    Guardian Full Name:*
                
                    Last 4 of Guardian's SSN:*

<%-----------------------------Ethnic Background--------------------------------------- ---------------------------------------------------------------------------- --%>

Ethnic Background

Ethnic background information is requested for Federal, State and Institutional reporting purposes only. Your choice to respond is greatly appreciated but, it is optional

Please select your Race from the following options (you can make more than one selection (if applicable))

By signing your name below you certify that all information given on the application is complete and accurate to the best of your knowledge. You understand that the undergraduate catalog and student handbook contain all pertinent information regarding Missouri Valley College's policies and procedures. You understand that you have a continuing responsibility to keep MVC informed of information relevant to our application. The electronic submission of this form constitutes your official signature as stipulated by Missouri Valley College and the State of Missouri.

*Applicant's signature and Date fields must be filled in order to submit your application.

Applicant's Signature (type full name)*

Date*

<%--

--%> Please correct the errors on this page, make sure that you are using the correct characters for your input, and make sure you have not left any required fields blank including the reCAPTCHA check <%-- -----------------------------------------------------%>

<%-- ""> --%>

<%--------------------------------------------------------------------- --%>

The information you submit on this application is kept as part of your educational record, and will be used to determine if you will be accepted to MVC. Missouri Valley College never collects user data for intentions of selling, distributing or monitoring user behavior to any party outside of the scope of the College’s operations. Missouri Valley College is fully committed to be in compliance with The Family Educational Rights and Privacy Act of 1974, commonly referred to as FERPA

If you are having trouble submitting your application, please make sure that you are following our data guidelines when you input your information (Look for automatic red labels when the application detects an issue with your input) , make sure that you are not using special characters/punctuation marks in the name/text fields other than Address text boxes, hyphens are accepted only in last names so please use spaces to separate names, use the correct date format displayed for date fields, us the correct SSN format in XXX-XX-XXXX (please add the dashes and double check your number for validity), also make sure you have values in all of the required boxes indicated by *. if you are still experiencing issues please contact us660-831-4000, or our technical support staff using email developer@moval.edu. Thank You!

<%-- This is the closing of the application, display one of the messages to let the applicant know of the current status of his/her application --%>

Application Complete

Thank you for completing the Missouri Valley College online application! You will be contacted by the admissions office upon review of your application, please allow 24-48 hours for processing and check your email (and spam folder) for further details from us!

We'd like to apologize to you as we are currently experiencing some technical difficulties, and your application did not process completely, you can try applying again, or you can contact us via phone 600-831-4076 or via email: mvcdc@moval.edu.

MVC Dual Credit Application

Personal Info

Primary Address

Guardian Information

This portion of this online form is to be completed by your legal Guardian:

Completing the following section is required by the Guardian and will act as his/her legal signature, agreeing to the statement above

Ethnic Background

Ethnic background information is requested for Federal, State and Institutional reporting purposes only. Your choice to respond is greatly appreciated but, it is optional

*Applicant's signature and Date fields must be filled in order to submit your application.

Application Complete