SouthJuly11 Survey

Thank you for your interest in Milwaukee Area Technical College, the Midwest's leading 2-year college.

To reserve your spot at the upcoming smartSTART please complete the information below.

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1. Please confirm you will be attending the smartSTART on Wednesday, July 11th, 5:30pm at the SOUTH CAMPUS.

Please confirm you will be attending the smartSTART on Wednesday, July 11th, 5:30pm at the SOUTH CAMPUS. Yes

No

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2. First name:

First name:

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3. Last name:

Last name:

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4. Complete the following:

Complete the following: Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

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5. Re-enter email address:

Re-enter email address:

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6. Date of birth:

	Month	Day	Year
Date of Birth	Date of birth: Date of Birth Month	Day	Year

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7. Have you attended another college?

Have you attended another college? Yes

No

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8. Semester and year you wish to begin?

	Semester	Year
Semester and Year	Semester and year you wish to begin? Semester and Year Semester	Year

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9. Campus you wish to attend?

Campus you wish to attend? Downtown - Milwaukee

Oak Creek

West Allis

Mequon

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10. Do you plan to seek financial aid assistance through MATC?

Do you plan to seek financial aid assistance through MATC? Yes

No

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11. Have you completed the Free Application for Federal Student Aid (FAFSA)?

Have you completed the Free Application for Federal Student Aid (FAFSA)? Yes

No

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12. MATC Program - First Choice (choose one)

	1st Choice
Program Choice	MATC Program - First Choice (choose one) Program Choice 1st Choice

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13. MATC Program - Second Choice (choose one)

	2nd Choice
Program Choice	MATC Program - Second Choice (choose one) Program Choice 2nd Choice

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14. MATC Program - Third Choice (choose one)

	3rd Choice
Program Choice	MATC Program - Third Choice (choose one) Program Choice 3rd Choice

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15. Are you a high school graduate?

Are you a high school graduate? Yes

No

16. If you did not complete high school and receive a high school diploma, have you completed a GED or HSED?

If you did not complete high school and receive a high school diploma, have you completed a GED or HSED? GED

HSED

No, I did not complete a GED or HSED

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17. Name of last high school?

Name of last high school?

18. Check all that apply

Check all that apply Veteran

Emancipated Youth

Food Share Participant

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19. What influenced you to check out MATC? (Check all that apply)

What influenced you to check out MATC? (Check all that apply) Family

Friend

Co-Worker

Recruiter

Teacher

Advertising

Past Experience