Supplemental Automotive Program Form

If you see this don't fill out this input box.

Before completing this form, be sure to complete a general admissions application. View application instructions

Student Status*

I am a new student and I have already submitted a new student application.I am a continuing student and I have reapplied to 杏吧原创.I have not submitted an application for new or continuing admission.

Before completing this form, you must first complete a general application for admissions to 杏吧原创.

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Personal Information

First Name*

Last Name*

Middle Initial

Phone Number*

Email Address*

杏吧原创 ID#

Numbers only. Do not enter a # symbol.

Date of Birth*

Please enter your Date of Birth

Home Address

Street Address

City

State

Zip Code

Program Selection

Please select your preferred program.

For Ford ACE, Subaru University, Mercedes Benz Campus, Mopar CAP and Nissan NTTA programs, select Automotive Technology A.A.S. (Day or Evening)

Program*

Automotive Maintenance and Light Repair CertificateAutomotive Technology A.A.S. Degree (Day)Automotive Technology A.A.S. Degree (Evening)Toyota T-TEN A.A.S. DegreeAutomotive Technology (General Motors ASEP concentration) A.A.S. DegreeAutomotive Technology (Honda PACT concentration) A.A.S. DegreeAutomotive Business A.A.S. DegreeAutomotive Business Certificate (Continuing Students)

NYS Driver License

All students applying to the Automotive Technology Program must provide their NYS Driver License or Permit number.

NYS Driver License Number*

Confirmation*

By checking this box I am hereby granting permission to 杏吧原创 to obtain a copy of my driving record from the NYS Department of Motor Vehicles for the purposes of verifying my ability to complete program-required cooperative hours at an approved dealership or repair facility.

杏吧原创

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