SWCCyou Portal

Citizenship Status

Personal Information

First Name (Legal) 

First Name (confirm spelling)

Middle Name

Last Name

Last Name (confirm spelling)

Suffix

Preferred First Name

What is your birth/maiden name?

What year were you born?

Date of Birth

If your date of birth listed above is incorrect, please contact the SWCC Admissions department after completing this application at 641.782.1421.

Date of Birth Hidden

Gender

Social Security Number

Failure to provide your Social Security Number (SSN) may cause duplicate records and delays in the processing of your year-end tax documentation. 

Ethnicity

Race (Choose one or more)

Marital Status

Citizen of:

If you are here on a visa, what type of visa is it?

Is English your first language?

Permanent Address

Street Address Line 1

Street Address Line 2

City

Province/State/Territory

Zip Code

Format: 12345 OR 12345-6789 OR 123456789 OR A1B 2C3

Country

Contact Information

Cell Phone Number

Primary Phone Number

Personal E-Mail Address

School Email Address

If applicable, please input a high school or other school email address here. 

Anticipated Academic Enroll Year

Anticipated Academic Enroll Term

Which best describes your current objective?

Enrollment Classification

Which location would you like to attend?

Enrollment Status

Program of Interest

Degree Code

High School Award Earned

High School Information

Did you receive a high school diploma? 

High School State 

High School City 

High School Attended

Are you homeschooled?

High School Graduation Date

If you have not yet graduated from high school, but plan to, use your anticipated graduation date.

If you earned an Adult High School Diploma, please enter your testing information in the following section.

High School Equivalency Diploma (GED) Information

Do you have an HSED (GED) or Adult High School Diploma?

HSED (GED) Test Date 

Where did you receive your HSED (GED)?

HSED (GED) Completion City

HSED (GED) Testing Center State

College History

***No need to add Southwestern Community College in this section, we've already got that recorded for you!

Other than SWCC, have you attended any other college or university?

College 1 State

College 1 City

College 1 Name

College 1 Last Attended

College 1 Type of Degree Earned

College 2 State

College 2 City

College 2 Name

College 2 Last Attended

College 2 Type of Degree Earned

Athletics

Please indicate what varsity sport(s), if any, you are interested in playing at Southwestern:

First Interest

Second Interest

Emergency Contact 1

First Name

Last Name

Address

City

State

Zip

Format: 12345 OR 12345-6789 OR 123456789 OR A1B 2C3

Country

Mobile Phone

Home Phone Number

Work Phone Number

Contact Relationship

Emergency Contact 2

First Name

Last Name

Address

City

State

Zip

Format: 12345 OR 12345-6789 OR 123456789 OR A1B 2C3

Country

Mobile Phone

Home Phone Number

Work Phone Number

Contact Relationship

Are you on academic/social probation at any other college?

Please explain the circumstances around your probation at the other school

Have you ever been convicted of a felony?

Please explain the circumstances of your felony conviction

Certification

By submitting this application, I certify that the above statements are true and correct to the best of my knowledge. I agree to abide by all approved policies as outlined in the current edition of the college catalog. I agree to report all changes, including name and address, to the Admissions Office with the understanding that my admission may be delayed, if all changes are not reported.

I agree that by submitting an application to Southwestern Community College, I give consent to Southwestern to store and use personal and academic-related information for all recruitment and academic records-related activities.  I also agree to allow Southwestern to use multiple forms of communication for the purpose of recruitment and academic-related information during my academic career.  I understand that if I do not agree to this statement I cannot be admitted to Southwestern.

It is the policy of Southwestern Community College not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental or marital status. If you have questions or complaints related to compliance with this policy, please contact: Lana Bartmess, Director of Human Resources/Equity/Title IX Coordinator (faculty or staff), Southwestern Community College, 1501 W. Townline St., Creston, IA 50801, phone, 641.782.1456, or email, TitleIXCoordinator@swcciowa.edu; Kim Bishop, Dean of Students/Deputy Title IX Coordinator (students), Southwestern Community College, 1501 W. Townline St., Creston, IA 50801, phone, 641.782.1413; or email, TitleIXCoordinator@swcciowa.edu; or the Director of the Office for Civil Rights, U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, phone, 312.730.1560, fax, 312.730.1576, or email OCR.Chicago@ed.gov.

Health/Disability Concerns

Applicants with health problems or disabilities, who may wish to request accommodations to succeed in their programs, should contact the director of student development at 641.782.1458.

Send an email acknowledgment of this submission to this email address: