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Monday, February 18, 2019
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If you would like to receive a Clark State information packet, please complete the following form.
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Personal Information
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City
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State:
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ZIP Code:
Phone number including area code
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County (All Ohio and some Indiana counties are listed, everyone else should use "Other County" from the bottom of the list)
<Select>
OH-Adams
OH-Allen
OH-Ashland
OH-Ashtabula
OH-Athens
OH-Auglaize
OH-Belmont
OH-Brown
OH-Butler
OH-Carroll
OH-Champaign
OH-Clark
OH-Clermont
OH-Clinton
OH-Columbiana
OH-Coshocton
OH-Crawford
OH-Cuyahoga
OH-Darke
OH-Defiance
OH-Delaware
OH-Erie
OH-Fairfield
OH-Fayette
OH-Franklin
OH-Fulton
OH-Gallia
OH-Gequga
OH-Greene
OH-Guernsey
OH-Hamilton
OH-Hancock
OH-Hardin
OH-Harrison
OH-Henry
OH-Highland
OH-Hocking
OH-Holmes
OH-Huron
OH-Jackson
OH-Jefferson
OH-Knox
OH-Lake
OH-Lawrence
OH-Licking
OH-Logan
OH-Lorain
OH-Lucas
OH-Madison
OH-Mahoning
OH-Marion
OH-Medina
OH-Meigs
OH-Mercer
OH-Miami
OH-Monroe
OH-Montgomery
OH-Morgan
OH-Morrow
OH-Muskingum
OH-Noble
OH-Ottawa
OH-Paulding
OH-Perry
OH-Pickaway
OH-Pike
OH-Portage
OH-Preble
OH-Putnam
OH-Richland
OH-Ross
OH-Sandusky
OH-Scioto
OH-Seneca
OH-Shelby
OH-Stark
OH-Summit
OH-Trumbull
OH-Tuscarawas
OH-Union
OH-Van Vert
OH-Vinton
OH-Warren
OH-Washington
OH-Wayne
OH-Williams
OH-Wood
OH-Wyandot
IN-Adams
IN-Allen
IN-Blackford
IN-Clark
IN-Dearborn
IN-Decatur
IN-Delaware
IN-Fayette
IN-Franklin
IN-Henry
IN-Jay
IN-Jefferson
IN-Jennings
IN-Ohio
IN-Randolph
IN-Ripley
IN-Rush
IN-Scott
IN-Switzerland
IN-Union
IN-Washington
IN-Wayne
IN-Wells
Other County
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Actual or anticipated HS Grad or GED Year
<Select>
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
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1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
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What type of student will you be when you start at Clark State?
<Select>
Adult/Traditional - (no previous college)
Returning (Previous Clark State student)
Transfer (Any other previous college)
Transient (Taking a few classes to tranfer to another college)
High School Prospect
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Anticipated Entry Term
<Select>
Spring B term (Begins March 18, 2019)
Summer, 2019 (Begins May 28, 2019)
Fall, 2019 (Begins August 19, 2019)
Indicate which majors you are interested in below. Departmental certificates are denoted with a DC and are not eligible for federal financial aid.
*
1st Choice
<Select>
Accounting
Accounting Cert.
Accounting- Executive Departmental Certificate (DC)
Agricultural Business
Agricultural Engineering
Arts Administration Certificate
Aviation Transfer (AA)
Aviation Transfer (AS)
Aviation Flight Certificate
Business Transfer - Wright State
Business Transfer - CSU
Childhood Development Associate (CDA) Certificate
Communication Studies Transfer
Chemical Dependency Certificate
Communications Certificate
Computer Aided Design (CAD) degree
Computer Aided Design Certificate (DC)
Computer Networking
Computer Software Development
Computer Networking - Technical Support
Computer Network Administration Certificate
Computer Network Infrastructure Certificate
Computer Programming Certificate
Computere Technical Support Certificate
Computer Web Development Certificate
Consumer Lending Departmental Certificate (DC)
Corrections
Court Reportiing - Judicial Reporting online with Stark State
Criminal Justice
Customer Service Certificate
Cybersecurity/Information Assurance
CyberSecurity Certificate
Diesel Technology - ATS
Diesel Technology Certificate
Early Childhood Education
Emergency Medical Services/Paramedic
EMT Basic Certificate
Electrocardiography (ECG) Certificate
Manufacturing Engineering Degree
Mechanical Engineering Degree
Engineering - Additive Manufacturing Certificate (DC)
Engineering - CNC: Computer Numerical Control Certificate (DC)
Engineering - Manufacturing Foundation Certificate (DC)
Engineering - Manufacturing Certificate (DC)
Engineering - Supervisory Control and Data Acquisition Certificate (DC)
Firefighter I Certification
Firefighter II Certificate
Firefighter/Transition Certification
Volunteer Firefighter (DC)
Food Science Technology
General Transfer - Associate of Arts
General Transfer - Associate of Science
Geospatial Tech.
Geospatial Precision Agr. Specialist Certificate (DC)
GIS Analyst Certificate
GIS Image Analyst Certificate
GIS Programming Certificate
Graphic Design
Health Information Technology Certificate
Healthcare Transfer (AA)
Healthcare Transfer (AS)
HeatingVentilation Air Conditioning- ATS
Heating Ventilation Air Conditioniong Certificate
Horticulture - Golf Course Option
Horticulture- Landscape Design Option
Horticulture- Natural Resources Option
Horticulture- Nursery Operations Option
Horticulture- Turf and Landscape Option
Industrial Technology Degree
Industrial Technology Maintenance Certificate (DC)
Information Services /Library Paraprofessional
Management
Management Certificate
Management - Banking
Management - Human Resources
Human Resource Certificate
Management - Insurance Option
Management - Logistics and Supply Chain
Logistics & Supply Chain Mgmt. Certificate
Management - Marketing
Management - Real Estate Broker
Management Certificate - Marketing
Medical Assisting
Medical Assisting Certificate
Medical Coding (Advanced) Certificate
Medical Coding Certificate
Medical Laboratory Technican
Multi-skilled Healthcare (ATS)
Multi-Skilled Healthcare Certificate
New Media
New Media Web Design Certificate (DC)
Nurses Aid Certificate
Occupational Therapist Assistant (Consortium Program)
Paralegl Transfer
Paramedic Certification
Paramedic Certification for Registered Nurses
Patient Care Technician Certificate
Phlebotomy Certificate
Physical Therapist Assistant
Police Academy
Practical Nursing
Precision Agriculture
Precision Agriculture - Technician Option
Precision Agriculture Certificate
Professional Office Admin.
Office Administration Certificate
Professional Office Admin- Medical Office
Professional Services Managment -ATS
Property Insurance Claims Certificate
Radiographic Imaging (Consortium Program)
Real Estate Certificate
Registered Nursing
LPN TO RN Transition
Paramedic to RN Transition
Respiratory Care (Consortium Program)
Small Business Certificates
Social Services
Social Work Trans. WSU
Supervisory Certificate
Teacher Education Transfer
Performance Art Transfer
Technical Theater Transfer
Transient
Undecided/Personal Int.
Welding Certificate (DC)
2nd Choice
<Select>
Accounting
Accounting Cert.
Accounting- Executive Departmental Certificate (DC)
Agricultural Business
Agricultural Engineering
Arts Administration Certificate
Aviation Transfer (AA)
Aviation Transfer (AS)
Aviation Flight Certificate
Business Transfer - Wright State
Business Transfer - CSU
Childhood Development Associate (CDA) Certificate
Communication Studies Transfer
Chemical Dependency Certificate
Communications Certificate
Computer Aided Design (CAD) degree
Computer Aided Design Certificate (DC)
Computer Networking
Computer Software Development
Computer Networking - Technical Support
Computer Network Administration Certificate
Computer Network Infrastructure Certificate
Computer Programming Certificate
Computere Technical Support Certificate
Computer Web Development Certificate
Consumer Lending Departmental Certificate (DC)
Corrections
Court Reportiing - Judicial Reporting online with Stark State
Criminal Justice
Customer Service Certificate
Cybersecurity/Information Assurance
CyberSecurity Certificate
Diesel Technology - ATS
Diesel Technology Certificate
Early Childhood Education
Emergency Medical Services/Paramedic
EMT Basic Certificate
Electrocardiography (ECG) Certificate
Manufacturing Engineering Degree
Mechanical Engineering Degree
Engineering - Additive Manufacturing Certificate (DC)
Engineering - CNC: Computer Numerical Control Certificate (DC)
Engineering - Manufacturing Foundation Certificate (DC)
Engineering - Manufacturing Certificate (DC)
Engineering - Supervisory Control and Data Acquisition Certificate (DC)
Firefighter I Certification
Firefighter II Certificate
Firefighter/Transition Certification
Volunteer Firefighter (DC)
Food Science Technology
General Transfer - Associate of Arts
General Transfer - Associate of Science
Geospatial Tech.
Geospatial Precision Agr. Specialist Certificate (DC)
GIS Analyst Certificate
GIS Image Analyst Certificate
GIS Programming Certificate
Graphic Design
Health Information Technology Certificate
Healthcare Transfer (AA)
Healthcare Transfer (AS)
HeatingVentilation Air Conditioning- ATS
Heating Ventilation Air Conditioniong Certificate
Horticulture - Golf Course Option
Horticulture- Landscape Design Option
Horticulture- Natural Resources Option
Horticulture- Nursery Operations Option
Horticulture- Turf and Landscape Option
Industrial Technology Degree
Industrial Technology Maintenance Certificate (DC)
Information Services /Library Paraprofessional
Management
Management Certificate
Management - Banking
Management - Human Resources
Human Resource Certificate
Management - Insurance Option
Management - Logistics and Supply Chain
Logistics & Supply Chain Mgmt. Certificate
Management - Marketing
Management - Real Estate Broker
Management Certificate - Marketing
Medical Assisting
Medical Assisting Certificate
Medical Coding (Advanced) Certificate
Medical Coding Certificate
Medical Laboratory Technican
Multi-skilled Healthcare (ATS)
Multi-Skilled Healthcare Certificate
New Media
New Media Web Design Certificate (DC)
Nurses Aid Certificate
Occupational Therapist Assistant (Consortium Program)
Paralegl Transfer
Paramedic Certification
Paramedic Certification for Registered Nurses
Patient Care Technician Certificate
Phlebotomy Certificate
Physical Therapist Assistant
Police Academy
Practical Nursing
Precision Agriculture
Precision Agriculture - Technician Option
Precision Agriculture Certificate
Professional Office Admin.
Office Administration Certificate
Professional Office Admin- Medical Office
Professional Services Managment -ATS
Property Insurance Claims Certificate
Radiographic Imaging (Consortium Program)
Real Estate Certificate
Registered Nursing
LPN TO RN Transition
Paramedic to RN Transition
Respiratory Care (Consortium Program)
Small Business Certificates
Social Services
Social Work Trans. WSU
Supervisory Certificate
Teacher Education Transfer
Performance Art Transfer
Technical Theater Transfer
Transient
Undecided/Personal Int.
Welding Certificate (DC)
3rd Choice
<Select>
Accounting
Accounting Cert.
Accounting- Executive Departmental Certificate (DC)
Agricultural Business
Agricultural Engineering
Arts Administration Certificate
Aviation Transfer (AA)
Aviation Transfer (AS)
Aviation Flight Certificate
Business Transfer - Wright State
Business Transfer - CSU
Childhood Development Associate (CDA) Certificate
Communication Studies Transfer
Chemical Dependency Certificate
Communications Certificate
Computer Aided Design (CAD) degree
Computer Aided Design Certificate (DC)
Computer Networking
Computer Software Development
Computer Networking - Technical Support
Computer Network Administration Certificate
Computer Network Infrastructure Certificate
Computer Programming Certificate
Computere Technical Support Certificate
Computer Web Development Certificate
Consumer Lending Departmental Certificate (DC)
Corrections
Court Reportiing - Judicial Reporting online with Stark State
Criminal Justice
Customer Service Certificate
Cybersecurity/Information Assurance
CyberSecurity Certificate
Diesel Technology - ATS
Diesel Technology Certificate
Early Childhood Education
Emergency Medical Services/Paramedic
EMT Basic Certificate
Electrocardiography (ECG) Certificate
Manufacturing Engineering Degree
Mechanical Engineering Degree
Engineering - Additive Manufacturing Certificate (DC)
Engineering - CNC: Computer Numerical Control Certificate (DC)
Engineering - Manufacturing Foundation Certificate (DC)
Engineering - Manufacturing Certificate (DC)
Engineering - Supervisory Control and Data Acquisition Certificate (DC)
Firefighter I Certification
Firefighter II Certificate
Firefighter/Transition Certification
Volunteer Firefighter (DC)
Food Science Technology
General Transfer - Associate of Arts
General Transfer - Associate of Science
Geospatial Tech.
Geospatial Precision Agr. Specialist Certificate (DC)
GIS Analyst Certificate
GIS Image Analyst Certificate
GIS Programming Certificate
Graphic Design
Health Information Technology Certificate
Healthcare Transfer (AA)
Healthcare Transfer (AS)
HeatingVentilation Air Conditioning- ATS
Heating Ventilation Air Conditioniong Certificate
Horticulture - Golf Course Option
Horticulture- Landscape Design Option
Horticulture- Natural Resources Option
Horticulture- Nursery Operations Option
Horticulture- Turf and Landscape Option
Industrial Technology Degree
Industrial Technology Maintenance Certificate (DC)
Information Services /Library Paraprofessional
Management
Management Certificate
Management - Banking
Management - Human Resources
Human Resource Certificate
Management - Insurance Option
Management - Logistics and Supply Chain
Logistics & Supply Chain Mgmt. Certificate
Management - Marketing
Management - Real Estate Broker
Management Certificate - Marketing
Medical Assisting
Medical Assisting Certificate
Medical Coding (Advanced) Certificate
Medical Coding Certificate
Medical Laboratory Technican
Multi-skilled Healthcare (ATS)
Multi-Skilled Healthcare Certificate
New Media
New Media Web Design Certificate (DC)
Nurses Aid Certificate
Occupational Therapist Assistant (Consortium Program)
Paralegl Transfer
Paramedic Certification
Paramedic Certification for Registered Nurses
Patient Care Technician Certificate
Phlebotomy Certificate
Physical Therapist Assistant
Police Academy
Practical Nursing
Precision Agriculture
Precision Agriculture - Technician Option
Precision Agriculture Certificate
Professional Office Admin.
Office Administration Certificate
Professional Office Admin- Medical Office
Professional Services Managment -ATS
Property Insurance Claims Certificate
Radiographic Imaging (Consortium Program)
Real Estate Certificate
Registered Nursing
LPN TO RN Transition
Paramedic to RN Transition
Respiratory Care (Consortium Program)
Small Business Certificates
Social Services
Social Work Trans. WSU
Supervisory Certificate
Teacher Education Transfer
Performance Art Transfer
Technical Theater Transfer
Transient
Undecided/Personal Int.
Welding Certificate (DC)
If you are interested in extracurricular activities, indicate below.
1st Choice
<Select>
Campus Events
Men's Baseball
Men's Basketball
Student Senate
Theatre
Women's Basketball
Women's Softball
Women's Volleyball
2nd Choice
<Select>
Campus Events
Men's Baseball
Men's Basketball
Student Senate
Theatre
Women's Basketball
Women's Softball
Women's Volleyball
3rd Choice
<Select>
Campus Events
Men's Baseball
Men's Basketball
Student Senate
Theatre
Women's Basketball
Women's Softball
Women's Volleyball
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February 2019
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Primary Campus
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Beavercreek
Bellefontaine
Online
Springfield
Xenia
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