Welcome to Southern Maine Community College

Request Personalized Information

Thank you for your interest in Southern Maine Community College. Please take a moment to fill out the form below. We will build a personal webpage based on your programs and activities of interest that will load automatically. You will also receive an email with a link to your personal webpage. A customized brochure, tailored to your interests, will be mailed to you.

Name and Address: *=Required Field

Name:

*First Name:

Middle Initial:

*Last Name:

Mailing Address:

*Address 1:

Address 2:

*City:

*State:

*Zip Code:

*Country:

Physical Address:

Same as Mailing Address:

*Address:

Address 2:

*City:

*State:

*Zip Code:

*Country:

Contact Information:

*Phone Number:

*Email Address:

**To receive your personalized web page, please provide your e-mail address. SMCC does not sell or rent its e-mail addresses.

About You:

Birth Date: (mm/dd/yy format)	Gender:	Male Female
When do you wish to begin classes at SMCC
High school graduation	High School last attended:
*How did you hear about SMCC:

Your interests:

Primary program of interest:
Secondary program of interest:
Primary activity of interest:
Secondary activity of interest:

Where are you interested in taking courses: (Please check all that apply.)

South Portland Campus
Midcoast Campus in Brunswick
Bath Center
Additional Satellite Locations

Please rank the following in order of importance, from 1 to 6 (Please use each number only once in your ranking.)

Cost
Location
Program(s) offered
Teacher/student ratio
Quality education
Transferability