Compass Career College is applying for reaffirmation of accreditation with the Commission of the Council on Occupational Education. Any persons wishing to make comments should write to: Executive Director, Commission of the Council on Occupational Education, 7840 Roswell Road, Bldg. 300, Suite 325, Atlanta, GA 30350, or submit their comments via the Council web site (www.council.org). Persons making comments must provide their names and mailing addresses.

Admissions Office: 985-419-2050 | 42353 Deluxe Plaza #16, Hammond, LA 70403

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Student Information

First name

Middle Initial

Last Name

Date of Birth

Social Security #

Sex *

FemaleMalePrefer not to say

Phone

US Citizen *

YesNo

Email Address

Permanent Address

City

State *

ZIP Code

Mailing Address

City

State *

ZIP Code

Emergency Contact Person

Emergency Contact Phone

Admissions Information

Program of Study *

Nurse Aide TrainingMedical Billing and CodingCosmetologyMedical AssistantPractical Nurse

Do you have a high school diploma or equivalent? *

YesNo

If "Yes", name of high school / equivalent

Year Graduated

If "No", highest grade completed

Year

List All Previous Colleges/Schools Attended:

Name

Location

Dates Attended

Name

Location

Dates Attended

Name

Location

Dates Attended

Name

Location

Dates Attended

Have you ever been dismissed, dropped, or suspended from any college, university, or school? *

YesNo

If yes, when and where:

Are you currently enrolled in another school? *

YesNo

If yes, where

Have you ever been enrolled in another school? *

YesNo

If yes, where

Cosmetology Applicants only - Have you ever been enrolled in another Cosmetology program?

YesNo

If yes, where

IMPORTANT NOTICES:

If you have transfer credits from another school you wish to apply toward your program at Compass you must submit these for consideration prior to signing the enrollment agreement. No more than 50% of your program clock hours can be transfer hours.
If you are eligible to receive benefits from a Veteran’s Assistance program you must submit transcripts from all previous colleges/schools attended.
Consumer Information disclosures may be accessed via the institution website at: http://www.compasscareercollege.net/consumer-information.html

Employment Information

Place of Employment

Position

Address

City

State

ZIP Code

Supervisor

Phone # OR Email

How long have you been employed there?

Parent Information

First Name

Middle Initial

Last Name

Home Phone

Cell Phone

Place of Employment

Phone

Relationship to Applicant

First Name

Middle Initial

Last Name

Permanent Address

City

State

ZIP Code

Home Phone

Cell Phone

Place of Employment

Phone

Relationship to Applicant

Reference Information

First Name

Middle Initial

Last Name

Permanent Address

City

State *

ZIP Code

Phone

Place of Employment

Relationship to Applicant

Other Information

Are you currently CPR certified through American Heart Association for Health Care Providers? *

YesNo

If yes, where:

How did you hear about Compass Career College: *

Internet (google search, etc)FacebookFriend, Current Student, Graduate (name)BillboardWork (name of company)Other (please specify)

Selective Service
I hereby swear or affirm under penalty of perjury in accordance with the requirements of the Military Selective Service Act, and the requirements of Louisiana state law R.S. 17:3151 that my selective service status is:

Choose One: *

26 or olderFemaleRegisteredMale, Under 18NoneOther

If "Other", explain here:

Upon admission, you will need to submit a copy of the following documents:

Valid government issued picture ID (driver’s license, passport, military id)
Social security card
High school diploma or equivalent
Any transcripts you wish to have evaluated for transfer credit. NOTE: students receiving Veteran’s Assistance benefits are required to submit transcripts from all schools previously attended.

Information Authorization

By completing this application for admission, I authorize Compass Career College and/or the Louisiana State Board of Regents to access my high school academic records. I also give permission for Compass Career College to provide personal information to the Louisiana State Board of Regents, the Louisiana State Board of Cosmetology, the Louisiana State Board of Practical Nursing, and/or any other regulatory agency requiring my: name, address, phone number and social security number for the purpose of verifying eligibility to begin and maintain enrollment in a program at Compass Career College. Further, I certify that all information provided on this form is complete and accurate. I understand that withholding information, or giving false information may make me ineligible for enrollment into Compass Career College. In compliance with the provisions of the “Family Educational Rights and Privacy Act” of 1974, I authorize the continuous release of my directory information to satisfy the annual reporting requirements imposed upon Compass Career College by its regulatory and accrediting agencies.

Please sign by typing your name here:

Date:

Referral Information

Do you have family or friends who may like to know more about the courses available at Compass Career College?

Name

Phone Number

Name

Phone Number

Name

Phone Number

Submit Form

I attest that the statements made in this application are true and correct to the best of my knowledge. I understand that withholding information or giving incorrect information may make me ineligible for admission and result in the cancellation of my enrollment in Compass Career College.

Type your full name here to sign:

Date:

PLEASE ONLY CLICK THE SUBMIT BUTTON ONCE. It can take a short time for your application to send.

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Admissions Office: 985-419-2050
42353 Deluxe Plaza #16, Hammond, LA 70403

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