What semester are you planning to attend Pawnee Nation College?*

(As appears on legal documents, i.e. birth certificates, court documents)

Legal Name*

Maiden /Other Names*

Date of Birth*

Please select which degree or certification program you are pursuing:*

Permanent Mailing Address*

Telephone Number(s)*

Email Address*

Name*

Relationship*

Please Specify Relationship*

Permanent Mailing Address*

Date of Birth*

Gender*

Marital Status*

Are you currently on or pending criminal probation or parole?*

If yes, please explain*

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Admission Application