Date of Submission:
Sunday, December 3, 2023 7:06:29 PM
Mid-Plains Community College Application for Admission
Transforming lives through exceptional learning opportunities for individual student success
Please complete all sections and then make sure to click the SUBMIT button on the final page to complete the application process. This may take a few moments, we recommend that you do not close out your browser until you see a confirmation of your submitted application that includes additional information for next steps.
If you have any questions on the application please contact Admissions: 308-535-3783 or firstname.lastname@example.org
Current Legal Name
This is your name as it appears on your Social Security Card, Immigration documents, and/or Passport. Your legal name will appear on your official MPCC records: admissions records, athletic eligibility, Federal Financial Aid, transcript/grade reports, and student account statements.
Last Name at Birth
MPCC recognizes that students may prefer to use a name other than their legal name to identify themselves, regardless if you have legally changed your name. MPCC reserves the right to reject inappropriate requests, such as offensive or derogatory language. Your campus name will appear on the following MPCC records: CampusWeb, Canvas, Class/Grade lists, commencement program, email, Dean's or President's list, and Campus Card.
Legal, Home Permanent Address
Do you currently live in the United States?
Address Line 1
Address Line 2
Address Line 2Municipality, state, or province, and postal code
What is your city of birth?
Phone Contact Information
Personal Email Address
Please provide a personal email address such as gmail, hotmail, yahoo, etc. Please note that high school email addresses are typically deleted after graduation.
Social Security NumberFormat: 000-00-0000
Your social security number is required for claiming education related costs on your IRS forms. If you do not have a social security number, please enter 000-00-0000.
Date of BirthMonth/Day/Year (MM/DD/YYYY)
Sex at Birth
If available options do not include your gender identity or personal pronouns and you wish to self-disclose, please select Options Do Not Apply and type your information here.
Country of Citizenship
Click Here To Learn More About the I-20 and Studying in the States
Are you required to have a student Visa and/or I-20 form to study in the United States?
Ethnicity and Race
In-State - US Citizen or Green Card holder who has lived in NE for 180 days prior to enrollmentOut-of-state - any Citizen (US, Non-US, Green Card, or Non-Green Card) who does not live in NE and does not qualify for LB239Border State - US Citizen or Green Card holder who is a resident of Colorado, Kansas, South Dakota, or Wyoming
I am a resident of the following state:
I have been a resident of this state since:*MM/DD/YYYY
Are you or did you attend high school in the United States? (this includes home school and online home schooling)
In which state are you currently attending or did you graduate from high school/home school?
Which high school did you graduate from?
Was your high school listed?
Are you working on or have you completed your GED?
When will you or when did you complete your GED?MM/DD/YYYYIf you are unsure of the day of the month, select the first day of the month.
Please enter your high school name, city, and state here, or enter "Home school" if home schooled
Non-United States High School
What year will you (or did you) graduate High School?
Have you attended or are you attending classes at a college other than Mid-Plains Community College? (Do not list MPCC below)Mid-Plains Community College includes:- McCook Community College- North Platte Community College- Community campuses in Broken Bow, Imperial, Ogallala, and Valentine
Which state was the college located?
Which college did you attend?
Was your college listed?
Please enter the college name, city, and state here:
Do you need to add an additional institution?
If you have any additional colleges to report, please email the list to email@example.com.
What is the highest level of education either of your parents, guardians, or primary caregivers have obtained?
Please choose yes if the following statements apply to you:
I am a single parent -
English is NOT my Primary Language -
I am a Homemaker seeking Career Skills -
Please select any of the following that apply to you:
I am currently employed:
Which of these statements best describes how you feel about attending college?
Including yourself, how many people are in your family?
My household income level is
If you have been diagnosed with a physical or mental impairment that limits your ability to participate in the educational experience offered by MPCC AND you wish to self-disclose, please indicate below.
Are you or a family member affiliated with the United States armed forces?
Are you a Veteran?
Which branch of military service?
Are you an Active Duty service member?
Are you a member of the National Guard?
Are you a member of the Reserves?
Are you a Veteran/Active Duty member or Spouse/Dependent of a Veteran/Active Duty member who has suffered a service related injury/illness?
Are you a spouse or dependent of a Veteran who is deceased?
Are you a spouse or dependent of Veteran/Active Duty service member?
Enrollment Year and Term
I plan to begin in the year
I plan to begin in the term
I plan to be enrolled
Type of Student
Are you a current high school student?
When do you plan to take classes with MPCC?
I plan to attend classes
Please select which best describes you:
Degree- I am planning to pursue a degree, diploma, or certificate at Mid-Plains Community College.OR- I plan to take courses at Mid-Plains Community College that I will transfer to another institution.
Non-Degree- I am taking classes for fun, for special interests, or other reasons and do not expect to earn a degree, diploma, or certificate.OR- I am taking classes at Mid-Plains Community College while attending another institution. (I am a visiting student.)OR- I am wanting to enroll in a CNA or Med Aide course
Map Program Code
I am currently a
Not 16 years Old?
If you are under 16, your application/registration will be reviewed by Administration to determine if registration may be allowed for your special situation.When submitting your registration form please also submit a high school transcript and any test scores. There is an upload link at the end of this application or have your school email them to firstname.lastname@example.org.
Non-Degree Seeking Candidate Application
Non-Degree (Enrichment)- I am taking classes for fun, for special interests, or other reasons and do not expect to earn a degree, diploma, or certificate.
Non-Degree (Visiting)- I am taking classes at Mid-Plains Community College while attending another institution. (I am a visiting student.)
Program of Interest
Degree Seeking Candidate Application
Will you be requesting financial aid?
Are you planning to live on-campus?
Identify the degree you plan to receive
Academic Transfer Program/Associate | Associate of Applied Science
Certificate | Diploma
What type of degree do you want to earn?
International Student Application
This application must be returned six months prior to anticipated enrollment date, along with the following:
I agree to the International Requirements:
Please Read Before Submitting
By pressing the submit button on this page
- I certify that all the information on this application is complete, true and accurate.- I agree to abide by the policies and regulations of MPCC.- I understand that any information given falsely or withheld may make me ineligible for admission.- I also agree to pay all tuition, fees and charges.- By providing my contact information I agree to let MPCC communicate with me via phone, email, mail, or text. To opt out of communication I can contact email@example.com.
Electronic Communication Consent
Before using electronic means (i.e. email) to communicate with you regarding financial matters, you must affirmatively consent to the use of an electronic record. This does not mean that MPCC will only send information electronically, but this consent allows us to communicate with you electronically as needed. By agreeing below, you are agreeing to the following:
I acknowledge that I have the right to cancel or modify my authorization, in writing, at any time and that changes will be effective the date MPCC receives my notification and are not retroactive.
Do you consent to electronic communication (e.g. Financial Aid and Student Account information)?
*Please note, by declining electronic communication consent you may experience delayed processing times related to Financial Aid and Student Accounts.
Unofficial Transcripts / Test Score Upload
Some courses require placement scores in order to enroll. If you have a copy of any unofficial transcripts or test scores, and would like to provide them now, please upload them here.
Please note - only 1 document per upload button.Files must be in .docx, .doc, .pdf, .png, .jpg, or .tif extentions.
Please do not close your browser until you receive the Successful Submission screen after clicking Submit - this may take a few moments.
MPCC ADA Statement
If you have a disability and require an accommodation while attending Mid-Plains Community College, please contact: Robin Rankin, North Platte Community College North Campus, 308-535-3637 or 800-658-4308 extension 3637, firstname.lastname@example.org; Chris Turner, North Platte Community College South Campus, 308-535-3715 or 800-658-4308 extension 3715, email@example.com; or Jacob Brandl, McCook Community College, 308-345-8128 or 800-658-4348 extension 8128 firstname.lastname@example.org; or email@example.com.