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Friday, May 26, 2017

Common Black College Application
Apply to any number of our Member Institutions for Only $35.00

 
Students can complete the Common Black College Application (CBCA) and apply to any number of our Member Institutions, at the same time, for only $35. The CBCA creates the potential opportunity for students to receive acceptance letters, financial aid packages and scholarship offers from several different colleges.
 
 
Please note that all colleges represented by
the Common Black College Application  give this application the same consideration as their institutional form.

Application Instructions:

 
1)   Please complete the application below and select your desired method of payment. 
   (Payment can be made by check or credit online)
 
 2)   Once payment has been confirmed, your application will be sent to all member institutions represented by CBCA.
 
3)   Please fax your transcripts and test scores to (404) 745-0124.
(Please note, some of our Member Institutions require to have transcripts and test score sent directly to their Office of Admissions.)
 
4)   Student essays and recommendations should be sent to all of the Member Institutions you are interested in attending.
 
5)   Please log onto our website at www.CommonBlackCollegeApp.com to check on the receipt of your application, transcript and test scores in our office.
 
6)   Please contact all of the colleges you are interesting in attending to check on the status of your admissions.
 
7)   The Common Black College Application fee can not be waived and we do not accept fee waivers because students are paying only $35 to apply to all Member Institutions.
 
8)   The $35 Common Black College Application fee is nonrefundable.
 
  
*    The Common Black College Application is not allowed to offer admission, scholarships, or financial aid on behalf of CBCA Member Institutions.
 

   
  Please begin by selecting the top 4 Member Institutions that you are most interested in attending (This application is made available to all Member Institutions):
 

College Preferences:

 1)   3)
 2)   4)
   

  Social Security # 

-- 
   

  Your Name: 

First Name Middle Name Last Name Suffix
   
  Address: 
  City: 
  State: 
  Zip Code: 
   
  Country: 
   
Residency:    Do you claim to be a RESIDENT of the STATE (above) for tuition purposes?
    Yes  No
   
     Have you EVER lived OUTSIDE of the STATE (above)?
    Yes  No
   
     Have you lived in the STATE (above) for AT LEAST the past year?
    Yes  No
   
     Have you attended a high school in the STATE (above) for at least one year?
    Yes  No
   
     Have you graduated from, or will you graduate from a high school in the STATE (above)?
    Yes  No
   
  Home Phone:  --
  Cell Phone:  --
   
  Student's Email :   
  Verify Email: 
   
  Choose a Password:   (must be 6 - 15 characters)
Confirm Password:    
   
  Citizenship:  U.S. Citizen Foreign
   If not a U.S. Citizen, please enter visa \ registration#
   
  Enrollment Term:  Part-Time Full-Time
   
  Status:  Freshman  Transfer Early Admissions  Non-Degree
   
  Which semester do you plan to enroll?
  Semester:  Fall Spring Summer        
 Enrollment Year:  
   
  Date of Birth: 
   
 Gender:  Male Female
   
 Marital Status:  Single Married Divorced
   
  High School Information:
   
  High School Attended: 
CEEB Code: 
  Graduation Year: 
   
  Who is your College Guidance / High School Counselor?
  Counselor Name: 
Counselor Email: 
   
  High school grades and key test scores:
 GPA:    ( If unsure, give best estimate )
     
 ACT Composite:    ( If unsure, give best estimate )
 ACT English:    ( If unsure, give best estimate )
 ACT Math:    ( If unsure, give best estimate )
 ACT Reading:    ( If unsure, give best estimate )
 ACT Science:    ( If unsure, give best estimate )
   
SAT Verbal:    ( If unsure, give best estimate )
SAT Math:    ( If unsure, give best estimate )
SAT Written:    ( If unsure, give best estimate )
   
SAT II Subject: 
   
 Major:    (Choose major of most interest.  Can change major later if needed. )
   
   Transfer Student Information (complete if transferring from another college)
   
If you are a student applying through the HBCU California Community College Transfer Guarantee program, you agree by submitting this application, to allow your name and the name of the community colleges you attended to be submitted to the California Community College Chancellor's office for reporting purposes.
 
Transfer College 1 Name: 
City: 
State: 
Country: 
Dates Attended:   From:   (mm/dd/yyyy) To:   (mm/dd/yyyy)
   
   Transfer Student Information (complete if transferring from another college)
Transfer College 2 Name: 
City: 
State: 
Country: 
Dates Attended:   From: (mm/dd/yyyy) To:   (mm/dd/yyyy)
   
   Referral Information (How did you find out about the CBCA application? )
Referrer Name:  (Name of person who referred you to this site)
Referrer Email:  (Email of person who referred you to this site)
    
  Father's Contact Information

Father's Name: 

First Name

   Last Name

Address: 
City: 
State: 
Zip Code: 
   
Home Phone:  --
Father's Employer: 
Title: 
Work Phone: 
   
  Mother's Contact Information

Mother's Name: 

First Name

   Last Name

Address: 
City: 
State: 
Zip Code: 
   
Home Phone:  --
Mother's Employer: 
Title: 
Work Phone: 
   
  Guardian Contact Information (If legal guardian is other than Mother or Father)

Guardian's Name: 

First Name

   Last Name

Address: 
City: 
State: 
Zip Code: 
   
Home Phone:  --
Guardian's Employer: 
Title: 
Work Phone: 
   
  Will you be applying for financial aid?
  Financial Aid:  Yes  No
   
  Do you plan to live on campus?
  Campus Residence:  Yes  No
   
  Have you ever been suspended from school?
(If yes, please explain)
  Suspension:  Yes  No    Explain:
   
  Have you ever been convicted of a felony?
(If yes, please explain the conviction.  You may be requested to provide a copy
of the court's disposition of your case.)
  Felony:  Yes  No    Explain:
   
  Religious Affiliation
(Information will not be used for admissions purpose)
  Religious Affiliation:  Baptist  Methodist  Catholic  Muslim  Other 
   
  Racial or Ethnic Origin
(Information will not be used for admissions purpose)
  Race/Ethnic 
 Background: 
Black / African American 
Asian 
Native Hawaiian / Other Pacific Islander 
American Indian / Alaska Native 
White 
I prefer not to identify my race / ethnic background 
   
  Are you of Hispanic or Latino Origin?
Yes  No
    
  Please list any extracurricular activities, special interests, or rewards you
have received while at high school:
Extracurricular Activities: 
   
  Are you interested in receiving information from our sponsors about student job opportunities?
  Job Opportunities:  Yes  No
   
   Certification (Please be sure to review your application for accuracy before submitting.)
 
 
I certify that all of the information I have given on this Common Black College Application is complete and accurate to the best of my knowledge. I understand that by withholding information it can lead to the denial of admission or expulsion from school. I agree to allow the information I have given on this Common Black College Application to be forwarded to all CBCA Member Institutions. 

I also understand by completing and submitting the Common Black College Application, I agree to allow my supplemental information (transcripts and test scores) to be submitted to the colleges that are Member Institutions of the Common Black College Application.

The Common Black College Application is not authorized to offer admissions, scholarships / financial aid. Please contact the colleges directly if you have questions concerning these matters.

Once submitted, you will be taken to our secure online payment screen where you may pay the $35 Common Black Application fee. After payment is complete, your application will be delivered to all CBCA Member Institutions. You will NOT be required to pay any additional application fees by our Member Institutions.
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