Chemeketa Community College Admissions Application

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Have you applied for admission to Chemeketa Community College in the past two years?
Note this includes if you've applied to any high school programs such as College Credit Now (CCN) or enrolled to take non-credit courses (driver's education, community education courses, etc.)

Yes

Unsure

You've indicated that you've applied to Chemeketa in the last two years--please let us know what action you are trying to take from the items listed below to help determine the correct process:

Why are you attempting to submit a new application?

I am/was a College Credit Now or underage student that needs to apply for college-level courses

I took non-credit classes and/or was in a non-credit program and need to apply for credit-level courses

I need to update my start term on my original application

I need to update my contact or other personal information

I need to change my program/focus/major

Other

Submit the Change of Academic Intent Form

You can update your major by filling out our Change of Academic Intent Form.

*IMPORTANT* You must read before clicking the link above

Clicking the link will prompt a pop-up that says "Leave site? Changes you made may not be saved." Please click "Leave" to navigate to the correct form.
The link will take you to a Google form and can only be accessed using your My Chemeketa Google account. If you are logged into a personal G-mail or Google account, please log out or use an incognito browser to see the form.
Don't know your MyChemeketa login information? Please call the Help Desk at 503-399-7899.

Submit the Change of Information Form

You can update your personal email and/or mailing address through your MyChemeketa account and can update other contact or personal information by filling out our Change of Information Form.

*IMPORTANT*: Clicking the link will prompt a pop-up that says "Leave site? Changes you made may not be saved." Click "Leave" to navigate to the correct form.

Submit the Change of Term Form

You can change your start term by filling out the Change of Admission Start Term.

*IMPORTANT*: Clicking the link will prompt a pop-up that says "Leave site? Changes you made may not be saved." Click "Leave" to navigate to the correct form.

You've indicated that there is some other reason you want to submit a new application. This may or may not be the correct process. See below for how to contact us.

Filling out the application may or may not be the correct process for you. See below for how to contact us.

If you think you need to fill out a new application, contact our Enrollment Services office to discuss your situation:

If you aren't sure if or when you submitted an admission application to Chemeketa, reach out to us. We are happy to help you!

Email: admissions@chemeketa.edu

Phone: 503-399-5001
Available Monday - Friday 8:00am to 5:00pm

In Person: Building 2, Room 201 on the Salem Campus
Open Monday - Friday 10:00am to 5:00pm

By Appointment: You Can Book Me

Submitting multiple applications will cause delays in processing your application and could impact your ability to register for classes in a timely manner. It is extremely important that you follow the instructions above to ensure you are going through the correct process.

DO NOT PRESS THE SUBMIT BUTTON. Pressing the submit button will give you an error. Please see above for instructions on what you need to do to move forward.

Fill out a new application with Chemeketa!

Please provide the information requested in the form fields below.

Required fields have an asterisk ∗ next to the field label

If you are having trouble filling out this application, please call us at 503.399.5001 from 8 am - 5 pm PT Monday through Friday or email us at admissions@chemeketa.edu for further assistance.

Name

Please enter your full legal first and last name as it appears on official government issued documentation. Do not use initials or nicknames.

Legal First Name*

Middle Name

Legal Last Name*

If you have ever held a different last name please note it in this field in order to help us match any previous records. If you have had more than one previous last name, provide the most recent.

Former Last Name

You can enter a preferred or chosen first name if you answer yes to the below question. More information about preferred name and how it is used at Chemeketa can be found on our public website. (go.chemeketa.edu/enrollment)

Do you have a preferred first name that is different than your legal first name?

Yes

Preferred First Name

ID Number/SSN

Chemeketa Community College does not require a Social Security Number (SSN) for admission. The college will use student social security numbers (SSN) for keeping records, complying with federal and state requirements, doing research, reporting, extending credit and collecting debts.

You may be required to provide your SSN to the college for compliance with specific federal and state regulations such as applying for financial aid, loans, grant programs and tax reporting requirements. Providing your SSN means that you consent to the use of the number in the manner described. Your SSN will not be given to the general public. You will be issued a Chemeketa student identification (ID) number (K#) to be used as your primary ID.

Please note that per OAR 589- 004-0400, if you choose not to provide your SSN, you will not be denied any rights as a student.

Social Security Number

ID Number/ K-Number WITHOUT the K (Ex: 00123456)
Please provide your Chemeketa student ID if you have one

Contact Information

Please enter your mailing address. Be sure to include the entire address (include NE, SE, NW, SW) or apartment number, suite number, etc.

Mailing Address*

Country

Street

City

Region

Postal Code

Please provide your personal email address (not a high school email account) so that we may contact you with your Chemeketa student login and registration information.

Personal Email Address*

Confirm Email Address*

Please provide your mobile/cell phone number on your application. If you do not have a mobile phone, please select a different phone type from the drop-down menu below.

Phone Type*

Phone Number*

Biographical Information

Have you entered or will you be entering the United States on a visa?*
If you are currently living in the United States without an active visa, answer "No"
If you are an international student, answer "Yes"
If you are unsure, call our office during business hours before submitting your application (503.399.5001)

Yes

Visa Type

Birthdate*

Current Age (Hidden)

Legal Sex*

Specific questions and answers have been designed by the federal government and Chemeketa is required to collect ethnicity and race information in the manner prescribed.

Please select whether or not you are from a Hispanic background.

Please select any descriptions which apply to your race (optional).

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific

White

Are you a US Veteran?*

Yes

Veteran Status (Hidden)

Submitted Flag - Hidden

Yes

High School Information

Please select from the dropdown list the level of high school completion which will most closely reflect your situation by the time you begin taking classes at Chemeketa.

High School Completion*:

Graduation/GED Completion Date*

Expected High School Graduation Date*

Age at Graduation (Hidden)

Age at GED (Hidden)

HS Grad Date - First Day of Term (Hidden)

Please select the location of the last high school you attended from the drop down below. If you were home schooled, please select "Home School" from the drop down. If your high school location is not within the United States please choose "Out of Country."

High School Location*

Type in the name of your high school and select the correct high school as options start to populate. If you do not see your high school listed, please select the "*I don't see my high school listed" option.

High School Name*

High School CEEB Code (Hidden)

Out of State CEEB Code (Hidden)

Out of Country CEEB Code (Hidden)

Home School CEEB Code (Hidden)

Level of Study High School (Hidden)

Educational Plans

Please select the first term you plan to start taking classes at Chemeketa. The month that the term begins is shown in parenthesis on the dropdown list. Please refer to our Dates and Deadlines on Chemeketa's public website for specific start dates and registration times

Which term do you plan to start taking classes?*

Age at start of term (Hidden)

First Day of Term Selected (HIDDEN)

term_started

Graduated before term or after?

NOTE: The information you provided indicates you are an underage student who does not attend a high school in Oregon and who will not graduate high school by the start of term. DO NOT SUBMIT THE APPLICATION.

To apply as an underage student just taking classes please click on this link to get to the correct application. You can also visit our High School Partnerships site (go.chemeketa.edu/highschool) for more information.

If you believe you are receiving this in error, please make sure that you have indicated your high school status at the time of your intended start term (not your current status) and choose the correct start term.

NOTE: The term you selected has already started.
If this selection was in error, please choose another term from the drop down menu above.

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Generate PIN

Credit Round

Degree-Seeking Round

Non-Credit Round

College Credit Now Round

International Round

Educational Goal:*

Because you have chosen “To transfer to a four year institution" as your educational goal you are also required to specify to which college/university you most likely plan to transfer. This will help our advisors better support you on your transfer pathway.

Transfer Institution*

Other College CEEB

A pathway is a group of related academic programs that provide degree and certificate tracks to reach your career goals. Please choose the academic pathway that most closely matches your desired goals Please visit our webpage on programs for more detailed information on each pathway.

Choose your academic pathway*

A track is a specific program within a pathway that will lead to a certificate, degree, or transfer. Please choose the track that most closely matches the field of study you wish to pursue.

Which track are you interested in studying within that pathway?*

Please select the focus which most closely matches your educational goal.

Choose a focus within the track you selected:*

Please select the reason which most closely matches your purpose in attending Chemeketa Community College.

Primary Reason for attending Chemeketa:*

Please Note: The following programs are not eligible for Financial Aid

Which best describes you?*

Please choose the level of college completion which most closely matches your education.

Prior College Experience*

Prior College Attended*

Undergraduate CEEB (Hidden)

Level of Study - Undergrad, Domestic (Hidden)

Level of Study - Graduate, Domestic, (Hidden)

Residency

Please select whether or not you will have been living in Oregon, California, Idaho, Nevada or Washington for at least 90 days prior to starting school at Chemeketa. Your answer to this question will help determine your tuition rate.

Will you have lived in Oregon, California, Idaho, Nevada or Washington for at least 90 days before the start of your admission term?*

Please be aware that if you applied to Chemeketa in the past and any of your biographical information has changed since the time of first attendance, Enrollment Services cannot update that information based on this application. This includes a new first name, last name, and/or new SSN. Changes to this information must be recorded separately in our Change of Information Form

Do you plan to be a part-time student?*

Yes

Fee Assessment Rate (Hidden)

Educational Goal*

What pathway are you interested in studying?*

What track are you interested in studying?*

Please choose a focus within this track.*

Thanks for selecting a track!

Which best describes you*:

Citizenship Information

Citizenship

Country of Birth

City of Birth

Native Language

Document Information

Passport Number

Passport Expiration Date

Have you already applied for a visa to study in the US?

Yes

Date Visa Awarded

Visa Expiration Date

Emergency Contact Information

Sponsor/Family Member/Friend Contact

First Name

Last Name

Relationship to You

Phone Number

Address

Agency Name

Do you give permission to this contact to discuss your Chemeketa record with Chemeketa staff?

Yes

Prior College Experience

What is the highest education level you have completed?*

College Name

College City

College Region

Int'l Undergraduate CEEB

Level of Study - Undergrad, International (Hidden)

Level of Study - Graduate, International

Financial Resources

To verify you have sufficient funds to meet your expenses, complete the following section. If you are married and plan to bring your spouse and any children, a proportionately larger amount must be certified. Please contact us for additional amounts required.

If married, will your family accompany you to the U.S.?

Yes

List the name(s) and relationship(s) below:

Family Member 1

First Name

Last Name

Relationship to you

Date of Birth

Family Member 2

First Name

Last Name

Relationship to you

Date of Birth

Family Member 3

First Name

Last Name

Relationship to you

Date of Birth

Funding Sources

Fund Type*

Name on Account*

Guaranteed Support (in USD)*

First Name*

Last Name*

Relationship to you*

Guaranteed Support (in USD)*

Name of Agency*

Agency Address*

Country

Street

City

Region

Postal Code

Guaranteed Support (in USD)*

Name of Sponsor*

Sponsor Address*

Country

Street

City

Region

Postal Code

Guaranteed Support (in USD)*

Fund Type

Name on Account*

Guaranteed Support (in USD)*

First Name*

Last Name*

Relationship to you*

Guaranteed Support (in USD)*

Name of Agency*

Agency Address*

Country

Street

City

Region

Postal Code

Guaranteed Support (in USD)*

Name of Sponsor*

Address of Sponsor*

Country

Street

City

Region

Postal Code

Guaranteed Support (in USD)*

Your responses have indicated you will not have graduated high school by the start of your first term at Chemeketa. If this is incorrect, please update your response to your high school completion status in the High School Information section above.

Which program are you applying for?*

The program you selected currently has a different application process*

To apply for a program in High School Partnerships, please use this link to get to the correct application. You can also visit our High School Partnerships site (go.chemeketa.edu/highschool) for more information.