Barton Home | Prospective Student Home

Inquiry Form

*Required Fields

Date (mm-dd-yy)

Last name*

First name*

Middle name*

Social Security Number

Current Address*

City*

State*

Zip Code*

County

Telephone No.* (111-111-1111)

E-mail address*(If you don't have an e-mail address, please type "none" in the text field.)

Male* or Female*    Birthdate* (mm-dd-yr)

I am presently a high school Sophomore Junior Senior

High School*

Year of high school graduation*

Major Area of Study*

I am interested in: (Check all that apply)  

Athletic Trainer

Meats Judging Team
Band Newspaper
Baseball Soccer - Men's
Basketball - Men's Soccer - Women's
Basketball - Women's Softball
Campus Christian Fellowship Student Ambassador
Cheerleading Student Government
College Quiz Bowl Tennis - Men's
Cougarettes Tennis - Women's
Danceline Theatre Arts
Debate Track/Cross Country
Golf - Men's Vocal
Golf - Women's Volleyball
HALO  
Honors Program Other

For more information you can write or call:

Admissions Office
245 NE 30th Road
Great Bend, KS 67530
(620) 792-9241 or 1-800-722-6842
FAX: (620) 786-1160
Email: desemok@bartonccc.edu