Application for Admissions
All form fields marked with ‡ are required for application.

I. PERSONAL INFORMATION

View Admissions Process

Entrance Term:

Admission Type:

Freshman: Transfer:

Application Type:

Regular: Early Decision:

* In submitting an Early Decision application, I enter into an agreement whereby, if admitted, I will enroll at Maine Maritime Academy and immediately withdraw all applications to other colleges.
Type AGREE: Type Initials:

Academic Major: (Select One) ‡

Marine Engineering Operations	Small Vessel Operations
Marine Engineering Technology	Small Craft Design (definition)
Marine Systems Engineering MSE 5yr Design/License Track (definition) MSE 4yr Design Track (definition) Power Engineering Technology Power Engineering Operations Marine Transportation Operations	Small Craft Systems (definition) Marine Biology Marine Science International Business & Logistics Interdisciplinary Studies **

** Permission to enroll in Interdisciplinary Studies is contingent upon a curriculum plan approved by the academic departments involved and the Academic Dean.

First Name:‡
Middle Initial:
Last Name:‡
Gender:‡	Male: Female:

Street Address:‡
City/Town:‡
State:‡
Zip Code:‡

What state does applicant claim as legal residence?‡

Phone:‡
Email:
Social Security:
Birthdate:‡
Age:‡
Birth City/State:‡

Mailing Address (if different from above):

Street Address:
City/Town:
State:
Zip Code:

Prior Military Service:‡	Yes: No:	Branch:
Dates of Service:		Eligible for V.A. Benefits: Yes: No:

*Optional: What is your ethnic background?*
African American, Black	American Indian or Alaska native	Asian or Pacific Islander
Hispanic	White	Other:

U.S. Citizen: ‡ Yes: No: If no, Country of Citizenship

Do you have permanent U.S. resident status? : ‡ Yes: No:

If yes: Indicate alien registration number - A# Years of residence in U.S.

How did you learn about Maine Maritime Academy?‡
Internet	Guidance Counselor	Family Member
Friend	Alumnus	Discovery Voyage
High School Visit	Mailing	MMA Coach
College Fair	Other:

Briefly outline your career ambitions:‡

Have you ever been suspended, placed on probation, or been dismissed from any school for any academic or disciplinary reasons or incurred other formal disciplinary action?‡
Yes No
Have you ever been convicted of a of a crime or are you currently involved in a criminal proceeding?‡
Yes No
(If yes to either/both, explain the circumstances in detail.)

II. ACADEMIC INFORMATION

High School:‡

City, State:‡

Graduation Date:‡

Other High Schools Attended:

City, State:

Dates Attended:

Director of Guidance: Phone Number:

Standardized Test Dates: Note the intended or actual dates of completion (mm/yy):
SAT
ACT
TOEFL (International Students only)
Have you ever been home schooled:‡ Yes No		What grade levels?

List any relatives who attend a maritime college or service academy.

Name:	Relationship:	College/Academy:	Dates:

Where else have you applied?
College	Major

TRANSFER STUDENTS
What other colleges have you attended?
College	Major	Dates of Attendance

III. FAMILY INFORMATION
	Father	Mother
Name:‡
Occupation:‡
Job Title:
Employer:
If deceased, year:

College Background:
College(s) Attended:

Degree(s) Earned:	Other	Other

Parental Information:	Divorced Year:	Separated
	Father Remarried	Mother Remarried
If any of the above apply, give full name, relationship, and address to the parent, guardian, or other person with whom you legally reside and to whom college reports should be addressed:
Name:		Relationship:
Street Address / Box No.:
Town:	State:	Zip:
Other members of the immediate family currently enrolled in college:
Name:	Relationship:	College

IV. ACTIVITIES, ACCOMPLISHMENTS, INTERESTS

An important part of the Maine Maritime experience is being involved. As you may have learned, your MMA education goes beyond the classroom. What do you have to contribute to the experience?

Clubs and Activities

Position

Awards/Honors

Fire Department

EMT

SCUBA

Class Officer

National Honor Soc.

Band

Drama

Drill Team

Junior ROTC

Outing Club

Boys/Girls State

Scouting

Yearbook/Newspaper

Student Gov't

Sea Scouts/Cadets

Athletics

Basketball

Cross Country

Football

Golf

Lacrosse

Sailing

Soccer

Softball

Ice Hockey

Volleyball

Other activities, accomplishments, hobbies, interests (include community involvement, academic awards, personal achievements, sea experiences, etc.)

Employment Information:
Employer:	Position(s) Held:	Dates of Employ:

Social Security Number Maine Maritime Academy has a strong commitment to ensuring the privacy and confidentiality of student records and will not disclose the Social Security Number (SSN) for any purpose without the expressed written consent of the student, except as mandated by law. Applicants are not required to include their Social Security Number on the application for admission but voluntary submission will minimize delays associated with other requested services within our campus administration. The number is used for (1) verifying student records, (2) identifying the student for purpose of financial aid eligibility, disbursement of financial aid loans and other debts payable to the institution, (3) compliance with state and federal reporting requirements, (4) U.S. Coast Guard licensing, (5) background checks for security sensitive co-operatives, and (6) citizenship related documents. Offer of Admission All offers of admission are extended with the understanding that your record of academic achievement and personal conduct will remain at least at the level as when we reviewed an application. Maine Maritime Academy reserves the right to rescind an offer of admission if it is learned that subsequent academic performance or personal behavior are viewed to be substandard or inappropriate. Fraudulent Reporting Applicants must provide accurate and complete information on all application documents. Intentional omission or falsification of information during the application process will result in the immediate rejection of the application. Application misrepresentation includes, but is not limited to: (1) false, omitted, or misleading information on the application, medical or immunization forms, financial aid disclosures or during the personal interview, (2) fake, forged, or altered transcripts, standardized test scores, or letters of recommendation. I certify that the information I have supplied on this application is complete and accurate. I understand that any falsification or misrepresentation may be cause for admission denial or subsequent dismissal.
Type your full name:‡
Agreement Statement (Type AGREE here.)‡
Date:‡	2010 MAR 12
Review admissions process
Send all supporting documentation to:	Director of Admissions Maine Maritime Academy 66 Pleasant Street Castine, ME 04420

NOTE: The submission of this form might take up to ninety (90) seconds to complete, thank you for being patient.

Application for Admissions All form fields marked with ‡ are required for application.

Application for Admissions
All form fields marked with ‡ are required for application.