All questions marked with an asterisk ( * ) are required to be answered.
Please use the Tab key to navigate between fields. Pressing the Enter key may delete any entered information.
PERSONAL INFORMATION
LEGAL FIRST NAME
LEGAL MIDDLE NAME
LEGAL LAST NAME
PREVIOUS LAST NAME(S)
DATE OF BIRTH (Ex. 01/01/2005)
SOCIAL SECURITY NUMBER
Your social security number is important for tax credit purposes
EMAIL ADDRESS
PLEASE CONFIRM EMAIL ADDRESS
CELL PHONE NUMBER
REQUESTED FHTC PASSWORD
Passwords Requirements:
PLEASE CONFIRM FHTC PASSWORD
HAVE YOU PREVIOUSLY ATTENDED FLINT HILLS TECHNICAL COLLEGE?
This includes classes or workshops which you may have taken several years ago
MAILING ADDRESS
STREET ADDRESS
CITY
STATE
ZIP CODE
COUNTY
COUNTRY
PERMANENT ADDRESS
EMERGENCY CONTACT INFORMATION
NAME
PHONE NUMBER
STATISTICAL INFORMATION
This information will only be used to fulfill state reporting requirements.
GENDER
MARITAL STATUS
ETHNICITY
RACE
ARE YOU A FIRST GENERATION COLLEGE STUDENT?
You would be considered a first generation college student if your parents or grandparents did not attend college.
CITIZENSHIP AND RESIDENCY
CITIZEN OF
CITIZENSHIP STATUS
MILITARY SERVICE AND NATIONAL GUARD
WILL YOU BE APPLYING FOR GI BILL BENEFITS?
ARE YOU A VETERAN?
MILITARY BRANCH
ARE YOU AN ACTIVE DUTY MILITARY SERVICE MEMBER?
ARE YOU MEMBER OF THE NATIONAL GUARD?
IN WHAT STATE?
ARE YOU MEMBER OF THE RESERVES?
MILITARY SERVICE BEGIN DATE
MILITARY SERVICE END DATE
ARE YOU A VETERAN, ACTIVE DUTY SERVICE MEMBER, OR THE SPOUSE / DEPENDENT OF A VETERAN OR ACTIVE DUTY SERVICE MEMBER THAT HAS SUFFERED A SERVICE RELATED INJURY OR ILLNESS?
ARE YOU THE SPOUSE / DEPENDENT OF A VETERAN OR ACTIVE DUTY SERVICE MEMBER WHO IS DECEASED?
ARE YOU THE SPOUSE / DEPENDENT OF A VETERAN OR ACTIVE DUTY SERVICE MEMBER?
HIGH SCHOOL INFORMATION
ARE YOU CURRENTLY ATTENDING HIGH SCHOOL?
CURRENT GRADE
EXPECTED GRADUATION YEAR
DID YOU GRADUATE FROM A HIGH SCHOOL?
WHAT STATE IS YOUR HIGH SCHOOL IN?
HIGH SCHOOL NAME
If there is no zip code, please enter 00000
GRADUATION YEAR
HAVE YOU EARNED A GED?
DATE GED WAS AWARDED
MAJOR/COURSE INFORMATION