Information Request

Fill out the form below to create your account. Your Email address MUST be valid and will become your username to log back into this site. Your next step will be to choose and complete the appropriate application.

Contact Information

First Name

Do you have a Middle Initial or Name?

Middle Name

Last Name

Birth Date

mm/dd/yyyy

Mailing Address

Address format examples: 123 Maple Lane OR 123 Maple Lane Apt C

Additional Address Information

Address format example: P.O. Box 4556 (when used in addition to street address)

City

State/Province

ZIP/Postal Code

Country

Cell Phone

Please enter your phone number as ###-###-####. Example: 419-555-3535

Home Phone

Please enter your phone number as ###-###-####. Example: 419-555-3535

Email Address

If you don't have an email account, please visit www.yahoomail.com or www.gmail.com to create a free e-mail account.

Confirm Email Address

What type of application will you be completing?

NC State General Admissions - For applicants who have already completed high school or earned a GED, or high school seniors who plan to attend AFTER high school graduation.

College Credit Plus (CCP) Admissions - For applicants in 7th-12th grade who plan to take some college courses while STILL in MIDDLE or HIGH SCHOOL.

Early College-Special Programs - For applicants who want to apply to any of the following programs:

College-NOW - For applicants who plan to attend college in their Junior and Senior years of high school INSTEAD of high school to earn an associate degree and high school diploma at the same time.
Galion's Early College Academy (GECA) - For Galion City School students entering their junior year of high school to take college courses full-time to earn an associate degree in Liberal Arts.

When do you plan to start taking classes?

Create Account

Contact Information

Account Information