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Online Application

Complete and submit our online application below. If you have questions about this application or would like to have a print application mailed to you, please contact us at (864) 941-8369.

Printable Application
If you prefer not to use this online form, you may also view the application instructions and print our application. Please mail it to the following address:

Piedmont Technical College
Office of Admissions
PO Box 1467
Greenwood, SC 29648-1467

First Name:

Middle Name:

Last Name:

Previous Name(s):

SSN#:

Mailing Address:

Mailing City:

Mailing State:

Mailing Zip Code:

If PO BOX was listed above, please provide permanent address below.

Permanent Address:

Permanent City:

Permanent State:

Permanent Zip Code:

County of Residence:

Home Phone:

Cell Phone:

Work Phone:

Gender:

Male
Female

Date of Birth:

Country of Birth:

Citizenship Status:

US Citizen
Other

If other, Country:

Visa Type:

Permanent Resident (Alien Registration must be present)
Student(F1)
Other

If other,:

Marital Status:

Race:

Black or African American
White
Hispanic of any race
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Two or more races

Email:

Emergency Contact Name:

Relationship:

Emergency Contact Phone:

High School Attended:

HS City:

HS: State:

HS Completion Date:

Did you Graduate HS:

Yes
No

Current HS Completion Status:

Diploma
Still in HS
Certificate of Completion
GED

If GED, Certificate:

GED State:

GED Completion Date:

College 1: Name:

College 1: City:

College 1: State:

Did you Graduate College 1:

Yes
No

College 1: Degree Earned:

College 2: Name:

College 2: City:

College 2: State:

Did you Graduate College 2:

Yes
No

College 2: Degree Earned:

College 3: Name:

College 3: City:

College 3: State:

Did you Graduate College 3:

Yes
No

College 3: Degree Earned:

Did you attend PTC prior to 1985:

Yes
No

When do you plan to enroll:

INTENDED MAJOR: Select ONE from below.

Administrative Office Tech:

Administrative Office Tech-Accounting Concentration
Administrative Office Tech-Legal Concentration
Administrative Office Tech-Medical Concentration
Administrative Office Tech-Medical Coding Concentration
Administrative Office Tech-Spanish Concentration
Office Technician Certificate
Microcomputer Software Specialist

Agriculture:

Horticulture Associate Degree
Basic Diversified Agriculture Certificate
Advanced Diversified Agriculture Certificate
Horticulture Landscape Mgt Certificate
Agric Ed Assoc in Science Transfer to Clemson
HRT/Turfgrass Assoc in Science Transfer to Clemson

Arts & Science:

Associate in Arts
Associate in Arts-Bridge USC
Associate in Arts-Bridge Lander
Associate in Arts-Bridge College of Charleston
Associate in Science
Associate in Science-Bridge USC
Associate in Science-Bridge Lander
Associate in Science-Bridge College of Charleston
General Studies Certificate
General Studies-Bridge USC
General Studies-Bridge Lander
General Studies-Bridge College of Charleston
Career Development

Automotive:

Major in Automotive Technology
Advanced Automotive Fundamentals Certificate
Automotive Fundamentals Certificate

Building Construction:

Major in Building Construction Technology
Construction Management Certificate
Carpentry Certificate

Business:

Accounting Certificate
General Business Assoc Degree
General Business Assoc Degree - Transfer Track
General Business Assoc Degree Accounting
General Business Assoc Degree -Management
General Business Assoc Degree -Office Mgt
Entrepreneurship Certificate

Commercial Arts:

Advertising Design Certificate
Desktop Publishing Certificate
Illustration Certificate
Photography Certificate

Computer Technology:

Advanced Web Development Certificate
Computer Tech Assoc Degree-Internet Concentration
Computer Tech Assoc Degree - Networking Concentration
Computer Tech Assoc Degree -Programming Concentration
PC Service Technician Cert

Criminal Justice:

Major in Criminal Justice

Engineering Technology:

Computer Aided Drafting Design
Electronic Engineering Technology Assoc Degree
Engineering Graphics Technology Assoc Degree
General Engineering Technology Assoc Degree
Mechanical Engineering Technology Assoc Degree
Mechanical Engineering Transfer Certificate
Electrical Engineering Transfer Certificate

Funeral Services:

Associate in Business (Funeral Services)
Funeral Services Education Certificate

Health Science:

Cardiovascular Associate Degree
Massage Therapy Certificate
Medical Assisting Diploma
Patient Care Technician Certificate
Phlebotomy Technician Certificate
Pharmacy Technician Certificate
Pharmacy Technician Diploma
Radiologic Technology Associate Degree
Respiratory Care Associate Degree
Surgical Technology Diploma
Veterinary Technology Associate Degree

Health Science Transfer w/Greenville Tech:

Biotechnology Certificate
Health Science Transfer – Dental Hygiene Certificate
Health Science Transfer – Medical Laboratory Technology Certificate
Health Science Transfer – Occupational Therapy Certificate
Health Science Transfer – Physical Therapy Assistant Certificate

HVAC Technology:

Heating Fundamentals Certificate
Heating, Vent and AC Technology Associate Degree
Refrigeration Applications Certificate

Human Services:

Early Care and Education Associate Degree
Early Care & Educ-Infant/Toddler Care Concentration
Early Childhood Development Certificate
Human Services Associate Degree
Human Services-Instructional Assistant Concentration
Infant Toddler Certificate
Special Needs and Disabilities Certificate

Industrial Electronics Technology:

Major in Vocational Technical Information
Electronical Maintenance Technician Certificate
Mechatronics Technology I Certificate
Mechatronics Technology Associate Degree
Industrial Electronics Technology Associate Degree

Machine Tool Technology:

Machine Tool Diploma
Machine Tool Operator Certificate
Machine Tool Technology Associate Degree
Electric Discharge Machining Certificate
Gunsmithing Certificate
Advanced Gunsmithing Certificate
Computerized Numerical Control Certificate

Nursing:

Major in Nursing
Advanced Placement Nursing Program
Practical Nursing Diploma

Pottery:

Professional Clay Certificate

Welding:

Welding Certificate - Journeyman
Welding Diploma

Other:

Transient
Undecided

Are you a legal resident of SC:

Yes
No

If yes, length of stay:

County of Residency:

If no, state of legal residency:

If less than 1 year, previous state:

Check one:

Independent
Dependent

If dependent, state of residency of person dependent on:

Before applying to college, was your previous income from another family member while you cared for home and family and that income is no longer available?:

Yes
No

How did you hear about PTC:

Newspaper Ad, Insert or Article
School Counselor
Billboard
Letter, Postcard, Flyer or Brochure
Friend or Family Attended
Website
Television Commercial
Word-of-Mouth
College Recruitment Fair
Radio Station
Other

I certify that all statements shown on this application are true and complete to the best of my knowledge. I also understand my image (photo or video) may be used by the college for public relations, marketing and/or publications. I understand that if I do not wish to have my image used for these purposes, I must file a written request available through the college’s marketing department, room 216A.

Signature (Name):

Declaration of Citizenship or Legal Presence in the United States: The South Carolina Illegal Immigration Reform Act (S. C. Code Ann. §59-101-430 (Westlaw 2008)) prohibits those unlawfully present in the United States from attending a public institution of higher education in South Carolina and from receiving a public higher education benefit. By signing this statement, you attest that you are a US citizen, a legal permanent resident in the United States, or an alien lawfully present in the United States. In addition, the college may require you to submit documentation that supports your claim. Any student providing false information may be subject to dismissal from the college. Any student who is found to be unlawfully present in the United States will be dismissed from the college.

Declaration Signature (Name):

Nondiscrimination Notice: Information requested on this application is required for state and federal records. Piedmont Technical College does not discriminate in recruitment, admissions, educational services or employment on the basis of race, sex, national or ethnic origin, age, religion or disability. Under the provisions of the Campus Security Act, statistics and campus security procedures are available in the general information section of the Piedmont Technical College Catalog.

Security Code:

Required field