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and any two of the following three: upper case, lower case,
special characters (for example: (){}!@$%^&*)
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 Maiden Name
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County*
What is your county of residence?
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E-mail Preference Yes No
Would you like to receive course info via e-mail?

Demographics

Birthdate*
mm/dd/yyyy Example: 09/08/1975
Gender* Female Male
How you heard about us*
Educational Level Some High School
Some College/Trade School
High School Graduate
College Graduate
None specified
Ethnicity* Caucasian/White (Non-Hispanic)
Hispanic
Black (Non-Hispanic)
Spanish-Surnamed Hispanic
Oriental-Asian or Pacific Islander
Native American or Alaskan Native
Unknown or None specified
Aleut/Athabascan Indian
Multi-Racial

Academic Info


Kansas City Kansas Community College
913-288-7660
www.kckcc.edu