Application for 92A MOS Army Logistics University

Richard Bland College is an equal educational opportunity institution, and, in keeping with this policy, the College makes no distinction in the admission of students or in any other of its official activities on the basis of race, sex, age, religion, handicap, sexual orientation, or national origin. All standards of the College including those governing student employment and financial aid are applied accordingly.

First Name*

Middle Name

Last Name*

Date of Birth*

Social Security Number*

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Address*

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Cell Phone Number*

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Applicant Email*

I am applying for admission for the following term semester:*

Fall Spring

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I am applying for admission for the following term year:*

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Are you a United States citizen?*

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State of Legal Residency:*

Gender*

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This information is required solely for determining compliance with federal civil rights laws, and your response will not affect consideration of your application.

Ethnic Identity

American Indian or Alaskan Native Asian Black/African American Native Hawaiian or Other Pacific Islander White/Caucasian Hispanic/Latino Race Unknown

Emergency Contact Name*

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Relationship*

Emergency Contact Address*

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ZIP Code

Emergency Contact Phone Number*

Emergency Contact Email

I certify that the information provided in this application is complete and correct to the best of my knowledge. I also certify that I have read and that I understand all the rules and regulations as published in the Richard Bland College Catalogue and the Student Handbook, including the statement on the Honor System, and if admitted, I agree to comply with and be governed by them and by all officially announced changes (publications available online at http://www.rbc.edu). I also understand that providing false or misleading information on the Application for Admission is a violation of the Richard Bland Honor Code and may result in not being admitted to the institution or my admissions being rescinded if dishonesty is discovered after my admission to Richard Bland College.*

I agree

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