Do not print the form and fill it out by hand.  
 

Enter all the required information online, use the "Print and Sign" button at the bottom of the form to generate the official PDF copy.
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The official copy will have a barcode in the lower left corner and a signature line at the end of the form.
 

After you print and sign the form, bring the form to the Enrollment Services Office on the first floor of Lynnwood Hall, OR fax the form to 425-640-1159, OR mail the form to: 
 
Enrollment Services 
Edmonds Community College 
20000 68th Ave W 
Lynnwood, WA 98036 

High School Student (under 18) Application
 Student Name     Last: (Surname):      First:      M.I.: 
 Student ID Number:    -- Help  Birthdate:  //   MM/DD/YYYY
 Year/Quarter:    Help  Social Security Number: -- Optional
  I refuse or am unable to provide my SSN/ITIN at this time.   
Initials:________________
 DISCLOSURE STATEMENT: To comply with federal laws, we are required to ask for your Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN). If you do not submit your SSN/ITIN, you will not be denied access to the college; however, you may be subject to civil penalties (refer to Internal Revenue Service Treasury Regulation 1.6050S-1 (e)(4) for more information) of a $50 fine in the event of an audit. If you choose not to provide your SSN/ITIN please check the “I refuse...“ box above and write your initials on the line provided.
Street Address:   Apt. # 
 City: State:  Zip: 
 Email:   Cell:   Home: 
 Previous Name(s):  
   Male           Female    
 
A. Services are available for students who have special needs due to a disability. Would you like our SSD staff to contact you with more information?    Yes           No 
B. Current High School: Expected Graduation: Yr:
C. Note: Students who are under the age of 18 and have not yet graduated from high school or received a GED are required to submit the following documents in addition to this application:
  • Parent Request for Underage Admission. This is needed only once and can be found on www.edcc.edu/es/forms.html or in the Enrollment Services office at EdCC.
  • Release letter from your high school counselor or school district. This is required every quarter and must be submitted each time you register for a class. The letter must mention EdCC along with what classes your counselor will allow you to take. If you are homeschooled, you must provide a copy of the Declaration of Intent or other documents given to the school district or state indicating your parent/s’ intent to homeschool you.
 Also, be aware that high school students who are not going through our Running Start or EdCAP programs must wait until open enrollment to register for classes each quarter.
  I understand the above and will bring the required documents with me.
D.  Which race(s) do you consider yourself to be? (Optional) (Mark up to two boxes)
  Alaska Native   Cambodian   Indonesian   Samoan
  American Indian   Chinese   Japanese   Taiwanese
  Arabian   Eskimo   Korean   Thai
  Asian – Indian   Fijian   Nepali   Tlingit
  Asian – Other   Filipino   Pacific Islander – Other   Vietnamese
  Black or African American   Hawaiian – Native   Pakistani   White
  Other Race: 
  ** If American Indian, please list name of enrolled or principal tribe: 
 Are you of Spanish/Hispanic origin? (Optional) (Please mark only one box)
  No, (not Spanish/Hispanic)   Yes, Mexican, Mexican-Am., Chicano   Yes, Spanish
  Yes, Central American   Yes, Puerto Rican  
  Yes, Cuban   Yes, South American   
  Yes, other Spanish/Hispanic: 
E.  How long do you plan to attend Edmonds Community College?
  One quarter   Up to two years, no degree planned
  Two quarters   Long enough to complete a degree
  One year   Don’t know
 What is your current work status while attending college?
  Full-time homemaker   Part-time on campus
  Full-time employment (including self and military)   Not employed, but seeking employment
  Part-time off-campus   Not employed, not seeking employment
 What is your prior level of education at entry to Edmonds Community College?
  Less than high school graduation   Certificate (less than two years)
  GED   Associate degree
  High school graduate   Bachelor’s degree or above
  Some post high school, but no degree or certificate
 What was your family status when you started at Edmonds Community College? Were you...
  a single parent with children or other dependents in your care
  a couple with children or other dependents in your care
  without children or other dependents in your care
F.  Note: Once you are no longer participating as a high school student, you will need to complete a new college admission application.
 I herby certify under penalty of perjury under the laws of the state of Washington RCW 9A.72.085 that to the best of my knowledge, all statements on this form are true and correct.
 
 
 
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