College in High School Application and Course Selection Form

Thank you for your interest in College in the High School. Please complete and submit the below form. Make sure to complete the course selection on the bottom of this page. Any questions do not hesitate to reach out ot the Educational Pathways Office, educationalpathways@cobleskill.edu.

* Required

Student Information

First Name

Middle Name

Last Name

Chosen First Name

Personal Pronouns

He/Him/His

She/Her/Hers

They/Them/Theirs

Social Security Number (numbers only)

Birthdate (Month/Day/Year)

Legal Sex

Female

Male

Gender Designation

Female

Male

Nonbinary

Permanent Home Address (include PO Box/ apartment number as appropriate)

Country

Street

City

Region

Postal Code

Home Phone

Daytime Phone (if different)

Email Address

Are you a US Citizen?

Yes

No

Are you a New York State Resident?

Yes

No

If your principal or permanent home has not been in New York State for a 12-month period immediately prior to the date you intend to enroll, you willbe considered an out-of-State student for tuition purposes. Please note that if you are financially dependent and your custodial parent lives in a state other than New York State, you will be considered a resident of that state.

County of Residence

Your response to the following racial/ethnic question is voluntary, but federal civil rights legislation and implementing regulations require the University to submit counts of its student body by racial/ethnic categories. Your cooperation, therefore, while voluntary, is essential to the accurate reporting of this information.

Academic Information

Have you previously been enrolled in SUNY Cobleskill College in the High School?

Yes

No

High School Name

adk school ceeb

afton hs ceeb

berne knoxceeb

bethlehem knoxceeb

catt ceeb

charlotte ceeb

c north ceeb

canjo ceeb

cobleskilskill ceeb

deruyter ceeb

duanesburg ceeb

edm ceeb

fabius ceeb

franklin

gilboa ceeb

green ceeb

hamilton ceeb

hfm ceeb

holland ceeb

hoosick ceeb

hudson ceeb

inst ceeb

jeff ceeb

marcelus ceeb

margaret ceeb

mass ceeb

middle ceeb

milford ceeb

morris ceeb

mount ceeb

new leb ceeb

north adk ceeb

oesj ceeb

remsen ceeb

roxbury ceeb

royalton ceeb

ss ceeb

saratoga ceeb

schenevus ceeb

schoharie ceeb

schuyler ceeb

scotia ceeb

sharon sp ceeb

shen ceeb

sout ca ceeb

stamford ceeb

taconic ceeb

unatego ceeb

vermont n country ceeb

patricia ceeb

windsor ceeb

worcester ceeb

Currently enrolled grade

Expected Date of Graduation

Signature

I understand that this application cannot be processed if it has not been completed according to instructions and that all information submitted is true to the best of my knowledge. Any deliberate falsification or omission of data may result in denial of admission or in dismissal.

Please type your name in place of your signature.

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College in High School Application and Course Selection Form