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Click HERE to download printable PDF form.

Please fill out the following information:
See list of majors online at: www.ivytech.edu
See list of majors online at: www.ivytech.edu
To the best of my knowledge, the information in this application is complete and accurate. When enrolled I agree to policies and regulations of Ivy Tech Community College of Indiana, and, if offered financial assistance, to observe all regulations required by state and federal assistance programs. I understand I am responsible for the security and confidentiality of any personal identification number (PIN) issued to me and that is serves as my signature. I agree that the college may send me materials, including but not limited to, financial aid, registration, and billing information via electronic means unless I notify the Registrar\'s Office otherwise. I understand that if I knowingly provide false information, including but not limited to, an incorrect Social Security Number, my enrollment may be revoked, and I may incur IRS fines and penalties. I authorize Ivy Tech Community College of Indiana to report my academic progress to particular high schools, universities and/or governmental agencies for the purpose of research, evaluation, or transfer opportunities. I verify my citizenship status in this application under penalties of perjury.


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