East Central College Application for Admission

Personal Information

Legal Name

First name

Middle name

Last name

Suffix

Do you have a chosen or preferred name?

Chosen/Preferred Name

This is an option for people who wish to use a name other than their legal name to identify themselves. If you use your legal name, you do not need to specify a chosen/preferred name.

ECC recognizes that faculty, staff and students may use names other than their legal name to identify themselves. These may include, but are not limited to, people who use their middle name instead of their first name, people who use nicknames of a legal name, people who use an anglicized name, or people who use a name that affirms their gender identity.

Yes No

Chosen/Preferred Name

First name

Middle name

Last name

Do you have any previous names? (Ex. Maiden or other legal name changes)

Yes No

Previous Name(s)

Ex. Maiden or other legal name changes

First name

Middle name

Last name

First name

Middle name

Last name

First name

Middle name

Last name

Add Name Remove Name

Select your citizenship status

U.S. Citizen Permanent Resident Not a U.S. Citizen (Enrolling in college credit) Not a U.S. Citizen (English Language classes only)

Do you have an F1 Visa?

Yes No

Please send a copy of your Permanent Resident Card to admissions@eastcentral.edu.

Please send a copy of your Visa to steffani.mccrary@eastcentral.edu, or apply for admission as an international student by completing the International Student Packet, available on the International Student page.

Mailing Address

City

State

ZIP code

Proof of residency in the East Central College district may be required.

Primary language

Birthdate

Students who have not completed a high school credential are not eligible for financial aid. Students who are pursuing a college degree and diploma program at the same time will need to provide proof of high school credential completion, before a college degree can be conferred.

Any student who wishes to give others, such as parents and/or supporters, access to their academic and financial records must complete a FERPA Privacy Waiver.

Social Security number

Confirm Social Security number

Entering an incorrect social security number will cause delays in processing your application.

Email (Do not use school email address)

Cell phone

Alternate phone

ECC often communicates by text message. Standard text rates will apply.

Are you a Veteran or are you currently serving in the U.S. Armed Forces?

Veteran Currently Serving Military Spouse/Dependent Not Applicable

Gender assigned at birth

Female Male

Are you Hispanic/Latino?

Yes No

Race (choose one or more) American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

Emergency Contact Information

Emergency Contact 1

First name

Last name

Best contact number

Relationship

Parent Guardian Spouse Other

Please state relationship

Emergency Contact 2

First name

Last name

Best contact number

Relationship

Parent Guardian Spouse Other

Please state relationship

Tuberculosis (TB) Screening

All new students intending to seek admission into East Central College must be screened for Tuberculosis (TB).
Please read the following set of questions:

Have you ever been diagnosed with TB?
Have you ever been in contact with someone who has, or had, TB?
Were you born outside the United States?
Have you engaged in frequent visits, prolonged visits, or military service outside the United States?
Have you been a volunteer or health care worker who served clients who are at an increased risk for active TB disease?

Check this box if you answered YES to any question above.

You will be required to submit tuberculosis test results within the past 12 months from a provider in the United States.

ACCESS and Disability Services

Access Services provides support for students who have documented disabilities by making reasonable accommodations in regard to academic instruction and other college related activities.

Students enrolling at East Central College who are seeking services for a disability must submit appropriate documentation and meet with an Access Counselor in order to receive services.

If you are interested in being contacted by an Access Counselor regarding accommodations, please check this box.

After submitting this form, please complete the Access Application form.

Criminal Background

Have you pled guilty to or been convicted of a felony?

Disclaimer: If you have a pending charge, you are required to notify us if you pled or have been found guilty.

Yes No

Education

When do you plan to begin classes or return to ECC?

Students who are English Language Learners or pursuing their high school equivalency should choose the first available enrollment listed below for this application. However, classes begin each month for these two programs.

Did you graduate from your high school/home school?

Yes No

Name of school (or Homeschooled)

What school did you attend?

When did you graduate?

Are you still attending high school/home school?

Yes No

Name of school (or Homeschool)

What school are you attending?

When do you plan to graduate?

Did you pass the GED/HSE test?

Yes No

What year did you pass the test?

Where did you take the test?

Have you previously enrolled in any college credit coursework, whether it was in high school or at another institution other than ECC? (i.e. Dual Credit, Dual Technical Credit, Associates Degree, etc.)

Yes No

If you have registered for any courses at other colleges or universities for previous semesters (including dual credit / dual enrollment), please request that each college or university send us your official academic transcript (regardless of whether you completed courses or received grades). Failure to list all colleges is considered falsification of records and may void your admission.

College Name

If you have additional colleges to list, please email the names and locations of those colleges to admissions@eastcentral.edu.

Add College or University Remove College or University

Academic Goals

What type of student are you?

Degree- or Certificate-Seeking – interested in degree or certification (only type eligible for financial aid)
Dual Credit – current high school student interested taking classes at high school
Dual Enrollment – current high school student interested in taking classes at an ECC location or online
Non-Degree – interested in taking just a course or a few
Visiting – interested in taking a course or a few and transferring it back to home institution
Adult Education – high school equivalency (formerly GED), preparation for college, military, or other placement exams
English Language Learner – English as a new language

What academic pathway do you intend to study at ECC?

Explore our Academic Pathways.

Which Arts & Humanities specialization do you intend to study?

Which Business specialization do you intend to study?

Which Career Technical specialization do you intend to study?

Which Early College path do you intend to take?

Which Education specialization do you intend to study?

Which Health Science specialization do you intend to study?

Which STEM specialization do you intend to study?

Which Social Science specialization do you intend to study?

At which ECC location do you plan to take the majority of your classes?

Statement of Financial Responsibility

Payment of Fees/Promise to Pay

I understand that when I register for any class at East Central College or receive any service from East Central College, I accept full responsibility for payment of all tuition, fees, and incurred charges due to East Central College.

I understand and agree that my registration and acceptance of these terms constitutes a promissory note agreement (i.e., a financial obligation in the form of an educational loan as defined by the U.S. Bankruptcy Code at 11 U.S.C. §523(a)(8) in which East Central College is providing me educational services, deferring some or all of my payment obligation for those services, and I promise to pay for all assessed tuition, fees, and other associated costs by the published or assigned due date.)

I understand and agree that if I drop or withdraw from some or all of the classes for which I register I will be responsible for paying all or a portion of tuition, fees and incurred charges such as but not limited to books, course fees, and program fees in accordance with the published tuition refund schedule. I have read the terms and conditions of the published tuition refund schedule and understand those terms are incorporated herein by reference. I further understand that my failure to attend class or receive a bill does not absolve me of my financial responsibility as described above.

Method of Billing

I understand that East Central College uses electronic billing (e-bill) as its official billing method, and therefore I am responsible for viewing and paying my student account e-bill by the scheduled due date. I further understand that failure to review my e-bill does not constitute a valid reason for not paying my bill on time. E-bill information is available at www.eastcentral.edu. I may log into eCentral, under the Financial Information section, click Payment Plan/Student Finance, Student Finance tab, and Account summary to view my account balance. My account balances may also be paid through eCentral. My statements can be generated and printed by clicking View Statements on the right side of the Account Activity Screen. If I do not have internet or printer access, account statements may be requested at any of our campus locations by presenting valid photo identification or by calling the Cashier’s Office at 636-584-6709 or 636-584-6739.

Payment of Fees and Payment Plan

All tuition, fees and other incurred expenses are due and payable to East Central College and are my responsibility to pay as the result of registration and/or other activity that incurred charges.

Payment options available for students:

Cashier’s checks, credit/debit cards; money orders, and traveler’s checks are acceptable payment methods.

Personal checks — The amount of the personal check may not exceed the amount due on my student account. Returned checks may result in being dropped from classes for non-payment.

MasterCard, American Express, VISA, and Discover — The Cashier’s Office accepts payment on the student’s account up to the credit limit of the cardholder. The charge amount may not exceed the amount due.

Payment Plan — Students that are unable to pay the full amount may enroll in a payment plan for the semester with Nelnet. Information for the Nelnet Payment Plan can be found in eCentral under Financial Information. Choose Payment Plan/Student Finance, Student Finance tab, then Nelnet Payment Plan.

Delinquent Account/Collection

Financial Hold:

I understand that if I fail to pay my student account bill or any monies due and owing East Central College by the scheduled due date, East Central College will place a financial hold on my student account, preventing me from registering for future classes, requesting transcripts, or receiving my diploma.

Drop for Non-Payment:

I understand that if I fail to pay my student account bill or any monies due and owing East Central College by the scheduled due date, I could be dropped from East Central College for non-payment.

Returned Payments:

I understand and agree that if a payment made on behalf of my student account is returned by the bank for any reason, I must repay the original amount of the payment plus a $25 returned check fee. I further understand that any check submitted for payment on account that is returned for insufficient funds will prompt a Cashier’s Office Hold on my student account. I understand that multiple returned payments and/or failure to comply with the terms of any payment plan or agreement I sign with East Central College may result in cancellation of my classes and/or suspension of my eligibility to register for future classes at East Central College. The hold can only be cleared once the bad debt is paid by cash or money order.

Collection Method:

I understand and accept that if I: (1) fail to pay my student account bill or any monies due and owing East Central College by the scheduled due date or (2) fail to make acceptable payment arrangements to bring my account current, East Central College will pursue collection efforts including referring the account to a collection agency and/or the Missouri Debt Offset Program. I understand that I shall be responsible for any and all attorney’s fees and expenses East Central College might incur while attempting to collect payment for the debt owed.

Schedule Modifications

I understand that prior to the semester census, I must follow proper procedures when withdrawing or dropping from courses to ensure proper charges. I will be charged for any withdrawal after the 100% refund withdrawal date. I understand that it is my responsibility to formally withdrawal from courses, and failure to do so will result in charges. I will be assessed appropriate tuition and fees for changes to my schedule. I understand that charges are assessed and refunded in accordance with the Semester Academic Calendar.

Financial Aid

I understand that aid described as “pending” on my Financial Aid Award does not

represent actual or guaranteed payment but is an estimate of the aid I may receive if I meet all requirements stipulated by that aid program. I understand that my Financial Aid Award is contingent upon my continued enrollment and attendance in each class upon which my financial aid eligibility was calculated. If I drop any class before completion, I understand that my financial aid eligibility may decrease and some or all of the financial aid awarded to me may be revoked.

If some or all of my financial aid is revoked because I dropped or failed to attend class, I agree to repay all revoked aid that was disbursed to my account and resulted in a credit balance that was refunded to me. Financial aid and scholarships will be applied to my student account, and I agree to allow any financial aid I receive to be used by East Central College to pay any and all charges assessed to my account at East Central College such as tuition, fees, service fees, fines, bookstore charges, or any other amount, in accordance with the terms of the aid and as set forth below.

I understand that financial aid awards can be viewed through eCentral under Financial Aid – Financial Aid Self Service. It is my responsibility to determine if my financial aid awards will cover all charges.

If any requested financial aid documentation is not received by the Financial Aid Office before the close of the regular registration period, I will be purged from my classes for non-payment. Aid is intended to be used for the semester for which it is applied.

Federal Aid Disbursement:

I understand that any federal Title IV financial aid that I receive, except for Federal Work Study wages, will first be applied to any outstanding balance on my account. Title IV financial aid includes aid from the Pell Grant, Supplemental Educational Opportunity Grant (SEOG), and Federal Direct Loan programs. I authorize East Central College to apply my Title IV financial aid to other charges assessed to my student account such as bookstore charges, service fees, and fines, and any other education-related charges. I further understand that this authorization will remain in effect until I rescind it.

Prizes, Awards, Scholarships, and Grants:

I understand that all prizes, awards, scholarships, and grants awarded to me by East Central College will be credited to my student account and applied toward any outstanding balance. I further understand that my receipt of a prize, award, scholarship or grant is considered a financial resource according to Federal Title IV financial aid regulations, and may, therefore, reduce my eligibility for

other federal and/or state financial aid (i.e., loans, grants, Federal Work Study) which, if already disbursed to my student account, may be reversed and returned to the aid source.

Complete Withdrawal

I understand that if I decide to completely withdraw from East Central College, I could owe monies back to East Central College as well as monies related to federal financial aid. I understand that the United States Department of Education requires students to repay a portion of their federal financial aid until 60% of the semester is completed. A complete withdrawal with money owed to East Central College will result in a hold being placed on my account to prohibit future enrollment as well as transcript availability. The balance must be paid in full to release this hold.

Communication

Method of Communication:

I understand and agree that East Central College uses e-mail as an official method of communication with me and that therefore I am responsible for reading the e-mails I receive from East Central College on a timely basis. Official communications will be sent to my East Central College e-mail.

Contact:

I authorize East Central College and its agents and contractors to contact me at my current and any future cellular phone number(s), email address(es) or wireless device(s) regarding my delinquent student account(s)/loan(s), any other debt I owe to East Central College, or to receive general information from East Central College. I authorize East Central College and its agents and contractors to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages, and personal calls and emails, in their efforts to contact me.

Updating Contact Information:

I understand and agree that I am responsible for keeping East Central College records up to date with my current physical addresses, email addresses, and phone numbers by contacting Student Services at 636-584-6588 or emailing studentservices@eastcentral.edu. The linked procedure is incorporated herein by reference. Upon leaving East Central College for any reason, it is my responsibility to provide East Central College with updated contact information for purposes of continued communication regarding any amounts that remain due and owing to East Central College.

Privacy Rights & Responsibilities

I understand that East Central College is bound by the Family Educational Rights and

Privacy Act (FERPA) which prohibits East Central College from releasing non-directory information from my education record without my written permission. Therefore, I understand that if I want East Central College to share information from my education record with someone else, I must provide written permission by following the procedure outlined at https://www.eastcentral.edu/registrar/ferpa/. I further understand that I may revoke my permission at any time as instructed in the same procedure.

IRS Form 1098-T

I agree to provide my Social Security number (SSN) or taxpayer-identification number

(TIN) to East Central College upon request as required by Internal Revenue Service (IRS) regulations for Form 1098-T reporting purposes. If I fail to provide my SSN or TIN to East Central College, I agree to pay any and all IRS fines assessed as a result of my missing SSN/TIN. I consent to receive my annual IRS Form 1098-T, Tuition Statement, electronically from East Central College. I understand that I can withdraw this consent or request a paper copy by contacting East Central’s Cashier’s Office, Monday through Thursday, 8:00 AM – 6:00 PM and Friday, 8:00 AM – 2:00 PM at 636-584-6739 or 636-584-6709.

Student Age

I understand and agree that if I am under 18 years of age when I execute this agreement that the educational services provided by East Central College are a necessity, and I am contractually obligated pursuant to the “doctrine of necessaries.”

Billing Errors

I understand that administrative, clerical or technical billing errors do not absolve me of my financial responsibility to pay the correct amount of tuition, fees, and other associated financial obligations assessed as a result of my registration at East Central College.

Entire Agreement

This agreement supersedes all prior understandings, representations, negotiations and correspondence between the student and East Central College constitutes the entire agreement between the parties with respect to the matters described, and shall not be modified or affected by any course of dealing or course of performance. This agreement may be modified by East Central College if the modification is signed by me. Any modification is specifically limited to those policies and/or terms addressed in the modification.

**East Central College has a right to modify or revise student charges regardless of whether they have been paid prior to the revision. **

By checking this box, I acknowledge that I have read, understand, and agree to the terms of the Statement of Financial Responsibility.

By submitting the application, I am certifying that I am the person who has completed the information on this application and that all the information I have provided is complete and accurate to the best of my knowledge. I am financially responsible for any tuition and fees accrued.

I understand that my name will appear on all college documents as listed above, unless I file a Student Information Form with the Student Service Center. Furthermore, I acknowledge that the college may accept and/or send transcripts to award credit for the purpose of transfer program completion.

I agree that East Central College may use photographic images and video or audio recordings of me, with or without my name and for any lawful purpose, including such purposes as publicity, marketing, illustrations, advertising, web content and/or other purposes without limitation, consistent with the mission of ECC. I voluntarily waive the right to inspect or approve such images and waive my right to any royalties or reimbursement, monetary or otherwise. This release is effective on the date of form submission and will remain in effect indefinitely.