Prospective Student Information Request

Please complete the form and we will be in touch to answer your questions.

Required

Please Fix these errors:

Personal Information

First Name

Middle Name

Last Name

Street Address

City

State

Zip Code

Email Address

Home Phone

Cell Phone

Cell Provider

By providing your cell phone number, you agree to receive import text messages from RACC.
If you do not want to receive text messages, please select the opt-out option.

I opt-out of receiving text messages from RACC

Birth Date

Gender

Intended Area of Study

Educational Background

GraduationYear

SchoolName

Select from the list. Select 'Other' if not found

SchoolName

Please fill out the information for your school

City

State

Educational Objective

Earn an associate degree or certificate
Earn college credits while I'm still in high school
Take a few classes while I explore my options
Take classes at RACC while I'm enrolled at another college or university

Returning Student

Have you previously taken coursework at RACC?

SSN

RACC ID

Comments

Additional Questions/Comments