Application for Reverse Transfers or Student NOT Currently Enrolled

Student ID# (not required)

First Name

Middle Name

Last Name

Maiden Name

Date of Birth

Last 4 digits of SSN

Current Mailing Address (Diploma will be mailed this address)

City

State

Zip

Email

What is your current phone number for questions regarding your application

What was your approximate last year of attendance?

Below will be the name that will appear on your diploma.  If you would like it to be changed, please make the changes below.

Please indicate the term you would like to apply for graduation.

Would you like to participate in the graduation ceremony?

Which ceremony would you like prefer to participate? 

Height 
(inches)

Weight
(pounds)

Chest Size
(inches) Click for diagram.

Cap Size
(inches) Click for diagram.

______________________________________________________

What program/degree are you requesting to receive?

If you are planning to use college credit from another college to complete your degree requirements, you must send official college transcripts to us.  Please have all official transcripts sent to the following address:

East Central Community College
ATTN: Admissions & Records
PO Box 129
Decatur, MS 39327

Transcripts can be sent electronically using e-script.

Application Date