Student information
Last Name: First Name: M.I.:
Social Sec. #: Date of Birth: Gender: M F
Mailing Address: City: State: Zip:
County: Country: Phone #:
Secondary Phone #: Email Address:
Drivers License Number: State Issued: Expiration:
Are you a U.S. Citizen: Y N

If you answer yes to any of the following, please explain on space provided
Have you had a moving violation in the past ten years? Y N
Have you ever been convicted, or adjudicated of a felony? Y N
If yes to any, details :

Emergency Contact Information
Name: Phone #:
Cell Phone #: Work Phone #:

Education

I have a (n): Please check one:
High School Diploma Adult Education Diploma HiSET/GED
Name of School/ Testing Center:
Date of Graduation/Diploma Issued:
City: State:
Have you previously attended Northern Maine Community College? (NMCC, NMTC or NMVTI):
Yes No Year:

If you have experience operating heavy equipment, please specify the type of equipment you've operated. If you have a resume, please send it with your application form.

Let us know how you learned about NMCC - Mechanized Logging Program (please check all that apply)
Website Friend/Relative NMCC Alumni Employer TV Radio Newspaper Other
What attracted you to the Mechanized Logging Operations Program?
Cost Size Close to home Program of Study Employment opportunities Other

Employment History - Please list three most recent employers

Most recent employer: Dates employed: to
Position: Duties:
Contact person for reference: OK to call for a reference? Y N

Employer: Dates employed: to
Position: Duties:
Contact person for reference: OK to call for a reference? Y N

Employer: Dates employed: to
Position: Duties:
Contact person for reference: OK to call for a reference? Y N

I hereby consent I do not consent
to the use by Northern Maine Community College to use a photograph of me in any publications, website, advertisement, report or other material promoting the College or the system. I hereby waive any and all rights to inspect or approve such photograph(s), and I release the College and the MCCS for any and all claims arising from use of the photograph(s).
By Clicking the `Apply Now` button below I certify that all information on this application is accurate and complete.

The application process is complete for Mechanized Logging Operations when the following are received:
Further screening of suitable applicants will also include:

Non-Discrimination Policy

Northern Maine Community College is an equal opportunity/affirmative action institution and employer. For more information, please call (207) 768-2791