What Will You Become?
Iowa Western Community College
 
Applicant Data
Please enter your full legal name.

* First Name/Given Name (Legal)
(Ex: Robert)
Middle Name
* Last Name/Family Name/Surname
Suffix
Preferred Name
(Ex: Bob)
* Date of birth (MM/DD/YYYY)
Social Security Number
Why do we ask for your SSN?We use your social security number to verify your identity for record-keeping purposes and to help match transcripts and other materials with your application for admission. Although it is not required for admission, your social security number is required to be considered for Financial Aid loans and grants.

In addition, Iowa Western is required to provide a Form 1098-T to each student (this information is also submitted to the IRS), which you will need in order to claim an education credit on your taxes, if you are eligible for such a credit, and we must have your social security number in order to do so.



* Email Address
* Mailing Address
* City
* State
* Zip/Postal Code
Home Phone Number
* Cell Phone Number




* Are you Hispanic/Latino(a)?
Yes
No


* To which racial group(s) do you belong? (Check all that apply.)
More info on Ethnicity/RaceEthnicity/Race Information
To comply with the U.S. Department of Education regulations concerned with Title VI of the Civil Rights Act, Iowa Western must report statistical summaries of the student body. This information is confidential and does not appear on academic records. Information regarding individual students is not disclosed outside the College without the student's consent.

Hispanic/Latino(a): a person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
American Indian or Alaskan Native: a person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment.
Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
African American/Black: a person having origins in any of the black racial groups of Africa.
Native Hawaiian or other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White: a person having origins in any of the original peoples of Europe, North Africa, or the Middle East.
American Indian or Alaskan Native
Asian
African American/Black
Native Hawaiian or other Pacific Islander
White
No Answer



* Gender
Male
Female


* What High School do you currently attend?
* What is your expected graduation year?

Disclaimers

* Iowa Western Community College is commited to providing equal educational opportunity and forbids unlawful discrimination on the basis of race, color, religion, national origin, physical or mental disability, age, sex, secual orientation, gender identity, ancestry, pregnancy, marital status, or medical condition

* 281-IAC 22.3 requires that a student anticipating enrollment under the Postsecondary Enrollment Options Act must inform the school district of the intent to participate and that the school district shall inform their students of the availability of the opportunity provided by the Act.

* If you drop or fail a course taken for IWCC credit, you may be held responsible to pay hour high school for the amount of the tuition, fees, and books. Check with your local school district to learn more about their repayment policies.

* Iowa Western’s FERPA practice is to protect all students post-secondary academic transcripts, even if they are still in High School. Click here to review Iowa Western’s Annual FERPA Notification to Students.

* If you have received this application it has been verified that you meet minimum Math and/or English placement standards.


Applicant Certification
By clicking the Submit button below, I hereby certify that the above information is true and correct, and I agree to be governed by the regulations, policies, and standards of Iowa Western Community College


PLEASE CLICK SUBMIT ONLY ONCE
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