Intent to Return Form

This form is to be filled out by students who:
a) have attended SCC in the last 3 years and have been out of school for at least one year.
b) are current PSEO students who want to continue at SCC after high school graduation.

*If it has been more than 3 years since you attended SCC, you will need to complete the full SCC application.

STUDENT INFORMATION
Name Name * First Middle Last
STAR ID or Student Tech ID or last 4 digits of SSN *
Email *
Phone (Home or Cell) Phone (Home or Cell) * - ### - ### ####
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Birthday Birthday * / MM / DD YYYY
Former Name(s) if applicable
ADMISSIONS INFORMATION
Select semester and year you plan to return *

Select semester and year you plan to return Fall Spring Summer
Year *
Which campus do you plan on attending? *

Which campus do you plan on attending? Faribault North Mankato
Program you intend to return to:
Visit www.southcentral.edu for a list of program majors *
Select desired credential *

Select desired credential Certificate Diploma Associate of Applied Science (AAS) Degree Associate of Science (AS) Degree Associate of Arts (AA) Degree
If you have attended any other college/university since attending SCC, please list here. An official transcript will need to be submitted to the admissions office.
*If the college or university that you attended is part of the Minnesota State College and University system, we will request that transcript on your behalf.
ELECTRONIC SIGNATURE *

ELECTRONIC SIGNATURE By checking the box, I agree that all of the information included is true and complete to the best of my knowledge.

Intent to Return Form

Intent to Return Form

STUDENT INFORMATION

ADMISSIONS INFORMATION