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BT
12 0 0 12 469 583.698 Tm
.024 Tc
(   )Tj
ET
EMC
/P <</MCID 51>>BDC
BT
12 0 0 12 486.5509 583.698 Tm
0 Tc
(______)Tj
ET
EMC
/P <</MCID 52>>BDC
BT
12 0 0 12 522.5509 583.698 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 53>>BDC
BT
12 0 0 12 538 583.698 Tm
0 Tc
(________)Tj
ET
EMC
/P <</MCID 54>>BDC
BT
12 0 0 12 586 583.698 Tm
( )Tj
ET
EMC
/P <</MCID 55>>BDC
BT
8 0 0 8 27.5391 573.9479 Tm
(                                                                            )Tj
ET
EMC
/P <</MCID 56>>BDC
BT
8 0 0 8 173.4589 573.9479 Tm
(STREET)Tj
ET
EMC
/P <</MCID 57>>BDC
BT
8 0 0 8 196.5877 573.9479 Tm
(                                                                                        )Tj
ET
EMC
/P <</MCID 58>>BDC
BT
8 0 0 8 365.5475 573.9479 Tm
(CITY)Tj
ET
EMC
/P <</MCID 59>>BDC
BT
8 0 0 8 378.7635 573.9479 Tm
(                                                             )Tj
ET
EMC
/P <</MCID 60>>BDC
BT
8 0 0 8 495.8835 573.9479 Tm
-.0549 Tc
[(S)-54.9(TAT)-54.9(E)]TJ
ET
EMC
/P <</MCID 61>>BDC
BT
8 0 0 8 515.774 573.9479 Tm
0 Tc
(                      )Tj
ET
EMC
/P <</MCID 62>>BDC
BT
8 0 0 8 558.014 573.9479 Tm
(ZIP)Tj
ET
EMC
/P <</MCID 63>>BDC
BT
8 0 0 8 567.1981 573.9479 Tm
( )Tj
ET
EMC
/P <</MCID 64>>BDC
BT
12 0 0 12 26.2 553.496 Tm
-.0129 Tw
(Mailing Address )Tj
ET
EMC
/P <</MCID 65>>BDC
BT
9 0 0 9 100.0857 553.496 Tm
.024 Tw
(\(if different\))Tj
ET
EMC
/P <</MCID 66>>BDC
BT
12 0 0 12 138.7857 553.496 Tm
-.0369 Tc
0 Tw
(: )Tj
ET
EMC
/P <</MCID 67>>BDC
BT
12 0 0 12 151 553.496 Tm
0 Tc
(____________________)Tj
ET
EMC
/P <</MCID 68>>BDC
BT
12 0 0 12 271 553.496 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 69>>BDC
BT
12 0 0 12 289 553.496 Tm
0 Tc
(______________________________)Tj
ET
EMC
/P <</MCID 70>>BDC
BT
12 0 0 12 469 553.496 Tm
.024 Tc
(   )Tj
ET
EMC
/P <</MCID 71>>BDC
BT
12 0 0 12 486.5509 553.496 Tm
0 Tc
(______)Tj
ET
EMC
/P <</MCID 72>>BDC
BT
12 0 0 12 522.5509 553.496 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 73>>BDC
BT
12 0 0 12 538 553.496 Tm
0 Tc
(________)Tj
ET
EMC
/P <</MCID 74>>BDC
BT
12 0 0 12 586 553.496 Tm
( )Tj
ET
EMC
/P <</MCID 75>>BDC
BT
8 0 0 8 26.2852 543.746 Tm
(                                                                                         )Tj
ET
EMC
/P <</MCID 76>>BDC
BT
8 0 0 8 197.165 543.746 Tm
(STREET)Tj
ET
EMC
/P <</MCID 77>>BDC
BT
8 0 0 8 221.5477 543.746 Tm
(                                                                           )Tj
ET
EMC
/P <</MCID 78>>BDC
BT
8 0 0 8 365.5475 543.746 Tm
(CITY)Tj
ET
EMC
/P <</MCID 79>>BDC
BT
8 0 0 8 378.7635 543.746 Tm
(                                                             )Tj
ET
EMC
/P <</MCID 80>>BDC
BT
8 0 0 8 495.8835 543.746 Tm
-.0549 Tc
[(S)-54.9(TAT)-54.9(E)]TJ
ET
EMC
/P <</MCID 81>>BDC
BT
8 0 0 8 515.774 543.746 Tm
0 Tc
(                      )Tj
ET
EMC
/P <</MCID 82>>BDC
BT
8 0 0 8 558.014 543.746 Tm
(ZIP)Tj
ET
EMC
/P <</MCID 83>>BDC
BT
8 0 0 8 567.1981 543.746 Tm
( )Tj
ET
EMC
/P <</MCID 84>>BDC
BT
12 0 0 12 26.2 523.2941 Tm
(Phone )Tj
ET
EMC
/P <</MCID 85>>BDC
BT
9 0 0 9 56.908 523.2941 Tm
.024 Tw
[(\(inc)19.8(lude area codes\))]TJ
ET
EMC
/P <</MCID 86>>BDC
BT
12 0 0 12 124.1312 523.2941 Tm
[(:)36.9( ________________________   ________________________   ______________________)]TJ
ET
EMC
/P <</MCID 87>>BDC
BT
12 0 0 12 568.7451 523.2941 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 88>>BDC
BT
8 0 0 8 27.9874 513.5441 Tm
(                                                                                   )Tj
ET
EMC
/P <</MCID 89>>BDC
BT
8 0 0 8 187.3472 513.5441 Tm
(HOME)Tj
ET
EMC
/P <</MCID 90>>BDC
BT
8 0 0 8 206.5536 513.5441 Tm
(                                                                      )Tj
ET
EMC
/P <</MCID 91>>BDC
BT
8 0 0 8 340.9535 513.5441 Tm
(CELL)Tj
ET
EMC
/P <</MCID 92>>BDC
BT
8 0 0 8 357.4619 513.5441 Tm
(                                                                    )Tj
ET
EMC
/P <</MCID 93>>BDC
BT
8 0 0 8 488.0219 513.5441 Tm
(WORK)Tj
ET
EMC
/P <</MCID 94>>BDC
BT
8 0 0 8 506.3978 513.5441 Tm
( )Tj
ET
EMC
/P <</MCID 95>>BDC
BT
/TT6 1 Tf
10 0 0 10 27 498.5441 Tm
.0278 Tw
[(If any of your transcripts, test scor)18.1(es, etc. might arrive under any name other than those listed above, enter names her)18.1(e:)]TJ
ET
EMC
/P <</MCID 96>>BDC
BT
10 0 0 10 562.8289 498.5441 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 97>>BDC
BT
10 0 0 10 19 477.5441 Tm
(__________________________________________________________________________________________________________________)Tj
ET
EMC
/P <</MCID 98>>BDC
BT
/F5 1 Tf
12 0 0 12 589 477.5441 Tm
( )Tj
ET
EMC
/P <</MCID 99>>BDC
BT
/F2 1 Tf
12 0 0 12 19 457.144 Tm
.024 Tw
[(IN C)17.8(ASE OF EMERGENCY CONT)54.9(ACT)]TJ
ET
EMC
/P <</MCID 100>>BDC
BT
12 0 0 12 181.879 457.144 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 101>>BDC
BT
/F5 1 Tf
12 0 0 12 26.2 434.7441 Tm
[(Name:)36.9( )]TJ
ET
EMC
/P <</MCID 102>>BDC
BT
12 0 0 12 67 434.7441 Tm
(__________________________________)Tj
ET
EMC
/P <</MCID 103>>BDC
BT
12 0 0 12 271 434.7441 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 104>>BDC
BT
12 0 0 12 289 434.7441 Tm
0 Tc
(______________________________)Tj
ET
EMC
/P <</MCID 105>>BDC
BT
12 0 0 12 469 434.7441 Tm
.024 Tc
(   )Tj
ET
EMC
/P <</MCID 106>>BDC
BT
12 0 0 12 490 434.7441 Tm
0 Tc
(________________)Tj
ET
EMC
/P <</MCID 107>>BDC
BT
12 0 0 12 586 434.7441 Tm
( )Tj
ET
EMC
/P <</MCID 108>>BDC
BT
8 0 0 8 27.1739 424.9941 Tm
(                                                                 )Tj
ET
EMC
/P <</MCID 109>>BDC
BT
8 0 0 8 151.9739 424.9941 Tm
(LAST)Tj
ET
EMC
/P <</MCID 110>>BDC
BT
8 0 0 8 167.7797 424.9941 Tm
(                                                                                                      )Tj
ET
EMC
/P <</MCID 111>>BDC
BT
8 0 0 8 363.6196 424.9941 Tm
(FIRST)Tj
ET
EMC
/P <</MCID 112>>BDC
BT
8 0 0 8 381.595 424.9941 Tm
(                                                                        )Tj
ET
EMC
/P <</MCID 113>>BDC
BT
8 0 0 8 519.8348 424.9941 Tm
(MIDDLE)Tj
ET
EMC
/P <</MCID 114>>BDC
BT
8 0 0 8 543.2509 424.9941 Tm
( )Tj
ET
EMC
/P <</MCID 115>>BDC
BT
12 0 0 12 26.2 404.5422 Tm
-.0129 Tw
[(Home Address:)36.9( )]TJ
ET
EMC
/P <</MCID 116>>BDC
BT
12 0 0 12 103 404.5422 Tm
0 Tw
(____________________________)Tj
ET
EMC
/P <</MCID 117>>BDC
BT
12 0 0 12 271 404.5422 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 118>>BDC
BT
12 0 0 12 289 404.5422 Tm
0 Tc
(______________________________)Tj
ET
EMC
/P <</MCID 119>>BDC
BT
12 0 0 12 469 404.5422 Tm
.024 Tc
(   )Tj
ET
EMC
/P <</MCID 120>>BDC
BT
12 0 0 12 486.5509 404.5422 Tm
0 Tc
(______)Tj
ET
EMC
/P <</MCID 121>>BDC
BT
12 0 0 12 522.5509 404.5422 Tm
.024 Tc
(  )Tj
ET
EMC
/P <</MCID 122>>BDC
BT
12 0 0 12 538 404.5422 Tm
0 Tc
(________)Tj
ET
EMC
/P <</MCID 123>>BDC
BT
12 0 0 12 586 404.5422 Tm
( )Tj
ET
EMC
/P <</MCID 124>>BDC
BT
8 0 0 8 27.5391 394.7922 Tm
(                                                                            )Tj
ET
EMC
/P <</MCID 125>>BDC
BT
8 0 0 8 173.4589 394.7922 Tm
(STREET)Tj
ET
EMC
/P <</MCID 126>>BDC
BT
8 0 0 8 196.5877 394.7922 Tm
(                                                                                        )Tj
ET
EMC
/P <</MCID 127>>BDC
BT
8 0 0 8 365.5475 394.7922 Tm
(CITY)Tj
ET
EMC
/P <</MCID 128>>BDC
BT
8 0 0 8 378.7635 394.7922 Tm
(                                                             )Tj
ET
EMC
/P <</MCID 129>>BDC
BT
8 0 0 8 495.8835 394.7922 Tm
-.0549 Tc
[(S)-54.9(TAT)-54.9(E)]TJ
ET
EMC
/P <</MCID 130>>BDC
BT
8 0 0 8 515.774 394.7922 Tm
0 Tc
(                      )Tj
ET
EMC
/P <</MCID 131>>BDC
BT
8 0 0 8 558.014 394.7922 Tm
(ZIP)Tj
ET
EMC
/P <</MCID 132>>BDC
BT
8 0 0 8 567.1981 394.7922 Tm
( )Tj
ET
EMC
/P <</MCID 133>>BDC
BT
12 0 0 12 26.2 374.3401 Tm
(Phone )Tj
ET
EMC
/P <</MCID 134>>BDC
BT
9 0 0 9 56.908 374.3401 Tm
.024 Tw
[(\(inc)19.8(lude area codes\))]TJ
ET
EMC
/P <</MCID 135>>BDC
BT
12 0 0 12 124.1312 374.3401 Tm
[(:)36.9( ________________________   ________________________   ______________________)]TJ
ET
EMC
/P <</MCID 136>>BDC
BT
12 0 0 12 568.7451 374.3401 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 137>>BDC
BT
8 0 0 8 27.9874 364.5901 Tm
(                                                                                   )Tj
ET
EMC
/P <</MCID 138>>BDC
BT
8 0 0 8 187.3472 364.5901 Tm
(HOME)Tj
ET
EMC
/P <</MCID 139>>BDC
BT
8 0 0 8 206.5536 364.5901 Tm
(                                                                      )Tj
ET
EMC
/P <</MCID 140>>BDC
BT
8 0 0 8 340.9535 364.5901 Tm
(CELL)Tj
ET
EMC
/P <</MCID 141>>BDC
BT
8 0 0 8 357.4619 364.5901 Tm
(                                                                    )Tj
ET
EMC
/P <</MCID 142>>BDC
BT
8 0 0 8 488.0219 364.5901 Tm
(WORK)Tj
ET
EMC
/P <</MCID 143>>BDC
BT
8 0 0 8 506.3978 364.5901 Tm
( )Tj
ET
EMC
/P <</MCID 144>>BDC
BT
12 0 0 12 26.2 344.1382 Tm
[(Rela)-9.8(tionship:)]TJ
ET
EMC
/P <</MCID 145>>BDC
BT
12 0 0 12 91 344.1382 Tm
(______________________________)Tj
ET
EMC
/P <</MCID 146>>BDC
BT
12 0 0 12 271 344.1382 Tm
( )Tj
ET
EMC
/P <</MCID 147>>BDC
BT
/F1 1 Tf
12 0 0 12 19 336.1382 Tm
( )Tj
ET
EMC
/P <</MCID 148>>BDC
BT
/TT2 1 Tf
12 0 0 12 19 319.1382 Tm
(RESIDENCY)Tj
ET
EMC
/P <</MCID 149>>BDC
BT
/F1 1 Tf
12 0 0 12 73 319.1382 Tm
( )Tj
ET
EMC
/P <</MCID 150>>BDC
BT
12 0 0 12 26.2 304.1382 Tm
.024 Tw
[(Ar)5.9(e you a United States citizen?)]TJ
ET
EMC
/P <</MCID 151>>BDC
BT
12 0 0 12 174.8895 304.1382 Tm
0 Tw
(                )Tj
ET
EMC
/P <</MCID 152>>BDC
BT
/F5 1 Tf
12 0 0 12 220.9695 304.1382 Tm
(YES )Tj
ET
EMC
/P <</MCID 153>>BDC
BT
/TT4 1 Tf
12 0 0 12 241.2375 304.1382 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 154>>BDC
BT
/F5 1 Tf
12 0 0 12 257.6779 304.1382 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 155>>BDC
BT
/TT4 1 Tf
12 0 0 12 274.1898 304.1382 Tm
(q)Tj
ET
EMC
/P <</MCID 156>>BDC
BT
/F1 1 Tf
12 0 0 12 283.2953 304.1382 Tm
( )Tj
ET
EMC
/P <</MCID 157>>BDC
BT
12 0 0 12 27 289.1382 Tm
.024 Tw
[(Ar)5.9(e you a r)5.9(esident of the )36.9(W)17.8(ayne County?)]TJ
ET
EMC
/P <</MCID 158>>BDC
BT
12 0 0 12 218.0895 289.1382 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 159>>BDC
BT
/F5 1 Tf
12 0 0 12 220.9695 289.1382 Tm
(YES )Tj
ET
EMC
/P <</MCID 160>>BDC
BT
/TT4 1 Tf
12 0 0 12 241.2375 289.1382 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 161>>BDC
BT
/F5 1 Tf
12 0 0 12 257.6779 289.1382 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 162>>BDC
BT
/TT4 1 Tf
12 0 0 12 274.1898 289.1382 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 163>>BDC
BT
/F1 1 Tf
12 0 0 12 290.6302 289.1382 Tm
.024 Tw
[(\(If y)5.9(es,)36.9( include documentation of r)5.9(esidenc)17.8(y\))]TJ
ET
EMC
/P <</MCID 164>>BDC
BT
12 0 0 12 492.4774 289.1382 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 165>>BDC
BT
12 0 0 12 27 274.1382 Tm
.024 Tw
[(Ar)5.9(e you 18 y)5.9(ears of age or older?)]TJ
ET
EMC
/P <</MCID 166>>BDC
BT
12 0 0 12 183.5295 274.1382 Tm
0 Tw
(             )Tj
ET
EMC
/P <</MCID 167>>BDC
BT
/F5 1 Tf
12 0 0 12 220.9695 274.1382 Tm
(YES )Tj
ET
EMC
/P <</MCID 168>>BDC
BT
/TT4 1 Tf
12 0 0 12 241.2375 274.1382 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 169>>BDC
BT
/F5 1 Tf
12 0 0 12 257.6779 274.1382 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 170>>BDC
BT
/TT4 1 Tf
12 0 0 12 274.1898 274.1382 Tm
(q)Tj
ET
EMC
/P <</MCID 171>>BDC
BT
/F1 1 Tf
12 0 0 12 283.2953 274.1382 Tm
( )Tj
ET
EMC
/P <</MCID 172>>BDC
BT
12 0 0 12 19 267.1381 Tm
( )Tj
ET
EMC
/P <</MCID 173>>BDC
BT
12 0 0 12 19 264.1381 Tm
( )Tj
ET
EMC
/P <</MCID 174>>BDC
BT
/TT2 1 Tf
12 0 0 12 19 251.1381 Tm
-.0131 Tw
[(PRIOR ACADEMIC )-37.1(HISTOR)18.1(Y)]TJ
ET
EMC
/P <</MCID 175>>BDC
BT
/F1 1 Tf
12 0 0 12 146.2219 251.1381 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 176>>BDC
BT
12 0 0 12 27 236.1381 Tm
.024 Tw
[(Ha)5.9(ve you r)5.9(eceived a High Sc)5.9(hool Diploma?  )]TJ
ET
EMC
/P <</MCID 177>>BDC
BT
/F5 1 Tf
12 0 0 12 231.6533 236.1381 Tm
0 Tw
(YES )Tj
ET
EMC
/P <</MCID 178>>BDC
BT
/TT4 1 Tf
12 0 0 12 251.9214 236.1381 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 179>>BDC
BT
/F5 1 Tf
12 0 0 12 268.3616 236.1381 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 180>>BDC
BT
/TT4 1 Tf
12 0 0 12 284.8737 236.1381 Tm
(q)Tj
ET
EMC
/P <</MCID 181>>BDC
BT
/F1 1 Tf
12 0 0 12 293.9791 236.1381 Tm
( )Tj
ET
EMC
/P <</MCID 182>>BDC
BT
12 0 0 12 27 221.1381 Tm
.024 Tw
[(Ha)5.9(ve you r)5.9(eceived a GED? )]TJ
ET
EMC
/P <</MCID 183>>BDC
BT
/F5 1 Tf
12 0 0 12 151.3595 221.1381 Tm
0 Tw
(YES )Tj
ET
EMC
/P <</MCID 184>>BDC
BT
/TT4 1 Tf
12 0 0 12 171.6277 221.1381 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 185>>BDC
BT
/F5 1 Tf
12 0 0 12 188.0679 221.1381 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 186>>BDC
BT
/TT4 1 Tf
12 0 0 12 204.5798 221.1381 Tm
(q)Tj
ET
EMC
/P <</MCID 187>>BDC
BT
/F1 1 Tf
12 0 0 12 213.6853 221.1381 Tm
.024 Tw
[(  Date Received ________________)]TJ
ET
EMC
/P <</MCID 188>>BDC
BT
12 0 0 12 385.4654 221.1381 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 189>>BDC
BT
12 0 0 12 27 206.1381 Tm
.024 Tw
[(Ha)5.9(ve you completed 12 hours of college cr)5.9(edits at )36.9(WCCCD with a g)-5.9(r)5.9(ade of )36.9(�C�)36.9( or better?  )]TJ
ET
EMC
/P <</MCID 190>>BDC
BT
/F5 1 Tf
12 0 0 12 444.0567 206.1381 Tm
0 Tw
(YES )Tj
ET
EMC
/P <</MCID 191>>BDC
BT
/TT4 1 Tf
12 0 0 12 464.3249 206.1381 Tm
.0278 Tw
(q  )Tj
ET
EMC
/P <</MCID 192>>BDC
BT
/F5 1 Tf
12 0 0 12 480.7651 206.1381 Tm
0 Tw
(NO )Tj
ET
EMC
/P <</MCID 193>>BDC
BT
/TT4 1 Tf
12 0 0 12 497.2771 206.1381 Tm
(q)Tj
ET
EMC
/P <</MCID 194>>BDC
BT
/F1 1 Tf
12 0 0 12 506.3826 206.1381 Tm
( )Tj
ET
EMC
/P <</MCID 195>>BDC
BT
12 0 0 12 19 199.1382 Tm
( )Tj
ET
EMC
/P <</MCID 196>>BDC
BT
/TT2 1 Tf
12 0 0 12 19 180.1381 Tm
.024 Tw
(HIGH SCHOOL:)Tj
ET
EMC
/P <</MCID 197>>BDC
BT
/F5 1 Tf
12 0 0 12 86.404 180.1381 Tm
[( ____________________________________  _______________________  _______    _____________)]TJ
ET
EMC
/P <</MCID 198>>BDC
BT
12 0 0 12 588.9163 180.1381 Tm
0 Tw
( )Tj
ET
EMC
/P <</MCID 199>>BDC
BT
8 0 0 8 27.1994 170.3881 Tm
(                                                                                 )Tj
ET
EMC
/P <</MCID 200>>BDC
BT
8 0 0 8 182.7191 170.3881 Tm
(SCHOOL)Tj
ET
EMC
/P <</MCID 201>>BDC
BT
8 0 0 8 208.3795 170.3881 Tm
(                                                                                       )Tj
ET
EMC
/P <</MCID 202>>BDC
BT
8 0 0 8 375.4193 170.3881 Tm
(CITY)Tj
ET
EMC
/P <</MCID 203>>BDC
BT
8 0 0 8 390.1635 170.3881 Tm
(                                         )Tj
ET
EMC
/P <</MCID 204>>BDC
BT
8 0 0 8 468.8835 170.3881 Tm
-.0549 Tc
[(S)-54.9(TAT)-54.9(E)]TJ
ET
EMC
/P <</MCID 205>>BDC
BT
8 0 0 8 488.0496 170.3881 Tm
0 Tc
(                      )Tj
ET
EMC
/P <</MCID 206>>BDC
BT
8 0 0 8 530.2895 170.3881 Tm
.024 Tw
[(GRAD DA)54.9(TE)]TJ
ET
EMC
/P <</MCID 207>>BDC
BT
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