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HACCpplication Day
First Name
Last Name
Email Address
Date of Birth
Phone
Cell Phone
Please provide a valid cell phone number if you would like to receive text message reminders about this event.
Country
Canada
United States
Afghanistan
Aland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote dIvoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic Peoples Republic Of
Korea, Republic Of
Kosovo
Kuwait
Kyrgyzstan
Lao Peoples Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic Of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova, Republic Of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French Part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich Islands
South Sudan
Spain
Sri Lanka
Stateless
Stateless
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province Of China
Tajikistan
Tanzania, United Republic Of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, British
Wake Island
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Address Line1
Address Line2
Foreign Address Line
City
ZIP/Postal Code
State/Province
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Military Americas
Military Europe
Military Pacific
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northern Mariana Islands
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Republic of Palau
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Are you a first-generation college student?
Please note that a first-generation college student is an individual whose parents did not complete a four-year college or university degree.
Yes
No
Have you ever served in the U.S. Armed Forces?
Yes
No
Optional Ethnic Information
The information you provide in this section will not be used in a discriminatory manner.
Ethnicity
Hispanic/Latino
Non-Hispanic/Latino
Optional Race Information:
Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:
American Indian or Alaska Native
Yes
No
Asian
Yes
No
Black or African American
Yes
No
Native Hawaiian or Pacific Islander
Yes
No
White
Yes
No
How did you learn about this event?
Billboard
Email from HACC
Facebook
Flyer
HACC Admissions Counselor
High School
News/Media
Other
Pandora
Phone Call
Postcard
Word of Mouth
Instagram
TikTok
Snapchat
Twitter
Internet ad
Streaming television
YouTube
When do you plan to start class at HACC?
Spring 2025 (January-May 2025)
Summer 2025 (May-August 2025)
Fall 2025 (August-December)
Winter 2025 (December-January; four-week term)
Spring 2026 (January-May)
Summer 2026 (May-August)
Fall 2026 (August-December 2026)
Spring 2027 (January-May)
Summer 2027 (May-August)
Winter 2026 (December-January; four-week term)
Which campus do you plan to attend?
Gettysburg Campus
Harrisburg Campus
Lancaster Campus
Lebanon Campus
York Campus
Academic Program
Addiction and Recovery Services, Associate in Applied Science
Administrative Office Management, Certificate
Advanced Automotive Specialty Skills, Diploma
Architecture, Associate in Applied Science
Architecture, Diploma
Art, Associate in Arts
Auctioneering, Diploma
Automotive Tech-GM (ASEP), Associate in Applied Science
Automotive Technology, Associate in Applied Science
Automotive Technology, Certificate
Baking and Pastry Arts, Certificate
Biology, Associate in Science
Building Construction Management, Associate in Applied Science
Building Construction Management, Certificate
Business Administration, Associate in Science
Business, Associate in Applied Science
Chemistry, Assoicate in Science
Communication, Associate in Science
Computer Information Security, Associate in Science
Computer Information Systems, Associate in Applied Science
Computer Information Systems, Certificate
Computer Networking Technology, Associate in Applied Science
Computer Networking Technology, Certificate
Criminal Justice, Associate in Arts
Culinary Arts, Associate in Applied Science
Culinary Arts/Catering, Certificate
Digital Art and Technology, Associate in Arts
Dual Enrollment High School
Early Care and Education, Associate in Applied Science
Early Childhood Care & Education, Certificate
Early Childhood-Elementary Education, Associate in Arts
Education (General), Associate in Arts
Electrical Technology, Associate in Applied Science
Electrical Technology, Certificate
Electronic Engineering Technology, Associate in Science
Engineering, Associate in Science
English as a Second Language
English, Associate in Applied Arts
Entrepreneurship, Diploma
Environmental Science, Associate in Science
Exercise Science, Associate in Science
Film and Theatre, Associate in Fine Arts
Fire Science Technology, Associate in Applied Science
Fire Science, Certificate
General Motors Technician Trainee I, Certificate
General Motors Technician Trainee II, Diploma
General Studies, Associate in Applied Science
GeoSpatial Technology, Associate in Science
GeoSpatial Technology, Diploma
Gerontology Certificate
Gerontology Diploma
Gerontology, Associate in Applied Science
Graphic & Interactive Design, Associate in Applied Science
Graphic Design, Certificate
Guest Student
Health Science, Associate in Applied Science
Healthcare Management, Associate in Applied Science
Hospitality Management, Associate in Applied Science
Human Services, Associate in Applied Science
HVAC/Refrigeration, Associates in Applied Science
HVAC/Refrigeration, Certificate
Industrial Technology Studies, Associate in Applied Science
Liberal Arts, Associate in Arts
Liberal Studies, Certificate
Management Information Systems, Associate in Science Degree
Math/Computer Science, Associate in Science
Mathematics, Associate in Science
Mechanical Engineering Technology, Associate in Science
Mechanical Technology, Certificate
Mechatronics, Associate in Applied Science
Mechatronics, Certificate
Medical Assisting, Certificate
Medical Laboratory Technician, Associate in Science
Music Audio & Recording Technology, Diploma
Music Business, Associate in Applied Science
Nanofabrication Manufacture Technology, Associate in Applied Science
Paralegal Studies, Associate in Applied Science
Paralegal Studies, Certificate
Personal Enrichment
Photography, Associate in Fine Arts
Photography, Certificate
Physical Sciences, Associate in Science
Police Science, Associate in Applied Science
Political Science, Associate in Applied Arts
Pre-Health Professions, Associate in Science
Professional Bookkeeping, Certificate
Psychology, Associate in Science
Radiology Informatics, Associate in Applied Science
Radiology Informatics, Certificate
Social Sciences, Associate in Arts
Social Services, Associate in Arts
Web Development & Design, Associate in Applied Science
Web Development & Design, Certificate
Welding Technology, Certificate
Welding, Diploma
Wellness and Health Promotion, Associates of Applied Science
Workforce Programs
How did you hear about this event?
Billboard
Email from HACC
Facebook
Flyer
HACC Admissions Counselor
High School
News/Media
Other
Pandora
Phone Call
Postcard
Word of Mouth
Instagram
TikTok
Snapchat
Twitter
Internet ad
Streaming television
YouTube
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