Apply to Helms College

Employee Application

Name *

First

Last

Preferred Name

Pronouns

He/Him, She/Her, They/Them

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Schools Attended

High School

Graduation Year

College

Graduation Year

Program of Interest

Intended Program

Campus

Augusta
Macon

Demographic Information

Hire Date *

SNAP Benefits

I am eligible for, or receiving, SNAP benefits.

Signature

By submitting this application, I attest that all of the above information is accurate and does not include false statements.

Application fee $25.00

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

*Email:

*Phone:

Date of Birth:

U.S. Citizen:

Gender:

Ethnicity:

PROGRAM OF INTEREST

School Attended

High School Graduate:

If Graduated, Graduation Date:

Expected Graduation Date:

Emergency Contact Information

Name:

Phone Number:

Relationship:

How did you hear about Helms College?

Personal Statement

I DECLARE under penalty of perjury that the statements and information submitted in this online application are true and correct.
I UNDERSTAND that all materials and information submitted by me for purposes of admission become the property of Helms College.
I UNDERSTAND that federal and state funds are available to assist me with the cost of college and that I can find out more by contacting the Financial Aid office.

Type your full name as it appears on the application in lieu of electronic signature.

*Electronic Signature:

Helms College admits students of any race, color, and national or ethnic origin and has adopted a nondiscrimination policy that is available from the Human Resources Department upon request.