Special Student Application (Non-Matriculant Status)
* Indicates the required items
*Please select the semester you are applying for:
Fall Winter Spring Summer Year:
Please enter your personal information:
*Social Security
(Format: 999-99-9999)
*Last Name
*First Name
Middle Initial
Other Name
*Date of birth
(Date Format: MM/DD/YYYY)
Email
(Email Format: abc@xyz.com)
*Sex
Male Female
*Marital Status
Single Married Other
Please enter your mailing address:
*Street address
*City
*State/Province
*Zip/Postal code
*Country
*Home Phone
(Format: 999-999-9999)
Work Phone
Citizenship Status:
U.S Citizen
Permanent Resident
Other:
Country of Citizenship
Ethnic Background
American Indian/Alaskan Native
Asian or Pacific Islander
Black, Non-Hispanic
Hispanic
White,Non-Hispanic
Other
Educational Background
Please check the highest level of education you have completed:
College Graduate (Specify degree held: )
Attended College, but did not graduate (completed college credits)
High School Graduate
Currently enrolled in High School
Attended High School, but did not graduate.
Please list all colleges you have attended, including Mercy College, listing the most recent college first.
College
Dates Attended (MM/DD/YYYY)
Degree
Campus Site:
Dobbs Ferry
Bronx
Yorktown
White Plains
Manhattan
Distance Learning
Admission Category (Please check one)
High School Student
Special Undergraduate (maximum 24 credits)
Special Graduate (Program Director's Permission is required)
Senior Citizen (non-degree seeking)
I plan to apply for a degree or certificate in