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NEO A&M College



Your current Institution is NEO
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Information Provide requested information to the best of your ability. An asterisk denotes a required field.

Required - indicates a required field.
Information Please indicate an active email address. This will be the main method of communication between you and the College.

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Information Provide legal or given name in the fields below.

Prospect Name
First Name: Required
Middle Name:
Last Name: Required

Information Identify the term in which you would like to begin coursework at NEO A&M College.

Prospect Entry Term
Term of Entry:Required

Information This address is where you wish to receive any mailings from the College. Please pay special attention to the phone number field as the 3rd section is the extension field.

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
State or Province:
ZIP or Postal Code:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information Date of Birth provided on legal documents.

Prospect Birthdate
Date of Birth:Required Month Day Year (YYYY)

Information Please indicate gender.

Prospect Gender
Gender:Required Male Female Not Specified

Prospect High School
Home Schooled (check for yes):
High School Code:
High School Name:Required
Address Line 1:
Address Line 2:
Address Line 3:
State or Province:
ZIP or Postal Code:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Information Please select the main major you wish to pursue while in attendance at NEO. This is not a multiple selection field.

Prospect Major

Information Please select all interests you wish to tell us about. You may select multiple interests by holding down the Ctrl key while making your selections.

Prospect Interests

Information How did you first learn about Northeastern Oklahoma A&M College?

How Prospect Learned About Us
How I Learned About NEO A&M College:

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Release: 8.7.2