Belmont College Application for College Credit Plus (CCP) Admission

To submit a College Credit Plus application to Belmont College, please complete this form.  For CCP Students: * notes a required field Belmont College requires a valid Social Security Number or Taxpayer Identification Number which is vital information used to comply with federal and state reporting requirements. Belmont College will not disclose your SSN or TIN without your consider unless required by law

CCP applicants are kindly requested to use a non-high school, non-parental affiliated email address for their application submission. Additionally, it is essential for students to diligently monitor their email correspondence throughout the application process. **

Name Information

First Name

Last Name

Middle Name

Suffix

Preferred First Name

Last Name at Birth (Maiden)

SSN

Gender

Birth Date

Marital Status

Citizenship Information

Citizen Of

Citizen Status

Race Information

Race (Choose one or more)

Ethnicity

Person

Format

Candidacy Questions

The first question on this page allows the user to choose the year and then dynamically populates the term based on the response to the first question. The second question's data source has a place holder called ##CandidacyYear that is associated with the year question on the Options tab. Defining ## placeholders in data sources requires that another question on the form be associated with that placeholder to be used as an input in the data source at the time it is executed. 

What year do you plan to begin your studies?

What term do you plan to begin your studies?

What type of student will you be?

Choose a program of study.

Contact Information

Address Line 1

Address Line 2

Zip Code

City

State

Country

Do you reside outside of the United States?

Have you lived in Ohio all of the last 12 months?

Have you lived in West Virginia for all of the last 12 months?

Primary Phone Number

Is your phone text capable?

Email Address

* NOTE - please list a Non-Parental/ Non-High School Email Address 

Selective Service Information

According to federal law, all male U.S. citizens must register with the Selective Service within one month after their 18th birthday. Male students aged 26 or younger must provide their Selective Service number to be eligible for financial aid. If you are required to have registered with the Selective Service, have you done so?

Selective Service Web Address

To register with the Selective Service, or to find your number, please visit www.sss.gov. Please notify the Belmont College Records Office as soon as possible with your Selective Service number.

Educational Background

Are you a high school graduate?

Do you have a GED?

High School Graduation Year (eg. 2024)

Has your father graduated from college?

Has your mother graduated from college?

School Information (Required)

State of Institution

Institution

Name of Institution

Degree

* Please use ADP - No Degree for the Degree Field

Mature Content Statement

I hereby acknowledge that I possess the necessary social and emotional maturity and I am ready to meet the demands of CCP and accept the responsibility and independence that the classroom requires.

I Acknowledge

Finish

Thank you for taking time to complete the College Credit Plus Application.  Please click submit below.  On the next screen, it will let you know the next steps to take for your application