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Participant Data
If you do not have a minor child who will participate, disregard this question.
Please enter N/A if not available in Other box
MM/DD/YYYY
Ethnicity This data is required for state and federal statistical reporting purposes only. There are certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, students are invited to voluntarily self identify their race or ethnicity. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations. When reported, data will be aggregated and will not identify any specific individual. This information is required but in no way will be used to evaluate your application.
Military
Residency
For Minor Participant This section should be completed only if the participant is a minor. If not, please skip this section.
Allowed file formats: .jpg, .jpeg, .zip, .rar, .png, .bmp, .pdf, .docx, .doc, .pptx, .ppt, .mp4, mp3, m4a, wav, .ics, .webp, .gif, .xlsx, .xls, .csv Maximum file size: 20Mb
The form can be accessed by clicking the “HOME” tab or "HCC Logo" tab at the top of the webpage. Scroll down to the bottom of the homepage to download the form under “RELATED FILES” section. Please fill out the form, scan or take pictures of the form and upload them to the respective fields below.
Consent and Agreements The information I have provided is complete and correct to the best of my knowledge. If my application is accepted, I agree to abide by the policies, rules and regulations at any school to which I am admitted. I authorize the College to verify the information I have provided. I further understand that the information submitted herein will be relied upon by the officials of the College in determining my admission and residency status for tuition purposes and that the submission of false information is grounds for rejection of my application, withdrawal of acceptance, cancellation of enrollment, and/or disciplinary action. 
Houston City College considers name, address, telephone, date of birth, degrees earned and dates, major field of study, dates of attendance, enrollment status, student classification and name of most recent previous institution attended, number of hours complete and in progress, directory information. This is done in compliance with the Texas Open Records Law.
MM/DD/YYYY

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