Rev. 1/15/20
CCAC HONORS PROGRAM APPLICATION
Name__________________________________________ CCAC Student Identification No._____________________
Address________________________________________________________________________________________
Street City State Zip
Telephone: __________________________ CCAC Academic E-mail:_______________________________________
High School ________________________________________________________ Birthdate: ___________
*Please note - applicants must be 18 years of age or older
Do you receive financial aid? Yes No
Have you earned any secondary or post-secondary degrees? Yes No
Degree earned: Associate’s Bachelor’s Master’s
School: ________________________________ Date: _____________ Major: _________________
*Please note that applicants who have earned a four-year degree are not eligible for Honors scholarships
Program at CCAC ________________________ Projected graduation date__________
Please note that you must be enrolled in a DEGREE program – not a certificate program to be eligible for the Honors Program.
Your CCAC Home Campus: Allegheny Boyce North South
Are you a full or part time student? Full-time Part-Time Hours on campus: Day Evening Both
At this time, do you intend to earn an Honors degree (by earning 15 Honors credits)? Yes No
___________________________________________________________________________________________________________________________________
TO BE ACCEPTED TO THE HONORS PROGRAM, ALL STUDENTS MUST BE ELIGIBLE FOR ENG 101 & MAT 090 (or above.)
PLEASE SELECT ONE OF THE FOLLOWING:
1. CURRENT CCAC STUDENT:
- Institutional GPA: ______ Total college-level credits completed: ______
- Minimum GPA 3.25
2. TRANSFER STUDENT:
- Must attach a copy of your transcripts from the transfer institution to this application.
- Total college-level credits completed: _________ Institution: ______________________________
3. NEW CCAC STUDENT ENTERING FROM HIGH SCHOOL:
- Attach a copy of your high school transcript to this application.
- High School GPA of 3.25 or greater: ________
_________________________________________________ _______________________
Student signature Date
Your signature above grants permission for the Honors Program to publish photographs taken of you at Honors event.
Please return your signed application to the Honors Program Office:
SCAN/EMAIL TO: honorsprogram@ccac.edu
MAIL TO: CCAC Honors Program
South Campus, L-462
1750 Clairton Road
West Mifflin, PA 15122
Phone: 412-469-4303
Fax: 412.469.6381
Office hours: Monday – Friday, 9:00 a.m. – 2:00 p.m.
Please note: our office is closed June and July
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