MCC Dual Degree Interest Form

Student Information

Type of Student*

First Name*

Last Name*

Mobile Phone Number

May we text you?

Yes

No

Mailing Address*

Country

Street

City

Region

Postal Code

Military Affiliation Information (Optional)

Are you a military affiliated student? (Active Duty, Veteran, Spouse, Dependent, National Guard/Reserve)

Yes

No

Are you active duty/veteran?*

Yes

No

What is your military status?

What is the military status of your parent/guardian or spouse?

Are you a military spouse/dependent?

Yes

No

What is the military status of your parent/guardian or spouse?

School Information

Current/Most Recent School*

Program Details

Select a major that interests you*

What term do you plan on entering K-State?*