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College Credit Plus Application
Submit this application along with high school transcripts and ACT and/or Accuplacer scores to the CCP Advisor, Student Success Center, 940 2nd Street, Portsmouth, Ohio 45662
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CCP Application
CCP
GR
HS
UG
Generate PIN = Yes
Generate PIN = Yes
Yes
No
App Submitted Flag = Yes
Yes
No
Round: Always Create (CCP)
Yes
No
Entry Type = CCP
CCP
First-Time Freshman
First-Time Freshman with College Credit
Guest/Non-Degree
International
Transfer
Shawnee ID # (if applicable)
Semester you plan to begin coursework at SSU:
Semester you plan to begin coursework at SSU:
Fall 2021
Spring 2021
Summer 2021
First Name
Middle Name
Last Name
Birthdate
Birthdate
January
February
March
April
May
June
July
August
September
October
November
December
1
2
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31
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
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1991
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1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Gender
Gender
Female
Male
Trans/Non-binary
Social Security Number:
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
Home Phone
Student Cell Phone Number
Would you like to receive text messages from SSU?
Would you like to receive text messages from SSU?
Yes
No
Email Address
Do you attend or will you be attending a career or technical center?
Do you attend or will you be attending a career or technical center?
Yes
No
Name of career or technical center
Name of Junior High/High School
Anticipated High School Graduation Year
Have you taken the ACT?
Have you taken the ACT?
Yes
No
*You will be required to submit a copy of your ACT or Accuplacer Next Gen test scores by April 9th, 2021 to complete your application.
Have you sent your ACT results to SSU?
Have you sent your ACT results to SSU?
Yes
No
Have you taken the Accuplacer Exam proctored through Shawnee State University?
Have you taken the Accuplacer Exam proctored through Shawnee State University?
Yes
No
Will you be sending in Next Gen Accuplacer scores from another institution?
Will you be sending in Next Gen Accuplacer scores from another institution?
Yes
No
*You will be required to submit a copy of your ACT or Accuplacer Next Gen test scores by April 9th, 2021 to complete your application.
Have you ever been convicted of a felony?
Have you ever been convicted of a felony?
Yes
No
Federal Law requires all male students who have reached their 18th birthday by the first day of the semester must be registered with the Selective Service. Failure to do so will result in the assessment of a selective service surcharge.
Federal Law requires all male students who have reached their 18th birthday by the first day of the semester must be registered with the Selective Service. Failure to do so will result in the assessment of a selective service surcharge.
I am a male student and will not be 18 prior to the start of the semester
I am registered with the Selective Service
Selective Service registration number
Where do you plan to take classes?
Where do you plan to take classes?
On Shawnee's Campus
At your high school (dual credit)
Both
Note: Students who attend Shawnee State University under the College Credit Plus program, under either Option A or Option B, must be Ohio residents and meet all requirements of that program.
Note: Students who attend Shawnee State University under the College Credit Plus program, under either Option A or Option B, must be Ohio residents and meet all requirements of that program.
Option A (Self-Pay)
Option B (High School Pay)
Resident Status for Past 12 Months
Resident Status for Past 12 Months
11 - Resident of Ohio
12 - Resident of another state
13 - Foreign: Visa
12 continued - County of Residence
13 continued - Visa Type
In the event of an emergency, notify:
Phone number of emergency contact
Submit
