Page 1

Required fields are marked with a *.

First Name (required)

Last Name (required)

Desired Level (required)

Desired Degree (required)

Desired Program (required)

Have you served in the U.S. Military or are you a military dependent?

Yes

Military Status

Military Branch

Page 2

Personal Email (required)

Verify Personal Email (required)

Mobile Phone ###-###-####

Yes, I would like to provide my mailing address. (You may be eligible to receive special tuition rates based upon your state of residency.)

Mailing Street

Mailing City

Mailing State

Mailing Zip/Postal Code

I give Charter Oak State College my consent to call, mail, text and email me about enrolling in the college. Message and data rates may apply. Text "STOP" and we will send a text message to confirm that you have been unsubscribed from text messages. To re-subscribe, reply “START”.

I DO NOT want to receive text messages from Charter Oak State College.

What is 7 + 14? (required)

Source

Phone

Contact Information