CDL Program Application

"*" indicates required fields

Directions: For CDL Program Application information and guidance see CDL Program Packet

Name*

First Last

Student ID#*

Student Phone*

E-mail Address*

Address*

Street Address Address Line 2 City State ZIP Code

Semester*

Location*

Flint River Campus

Butts County Center

When*

Day (8 week class)

Weekend Fri/Sat (Flint River Campus Only)

Internship (need advisor approval)

When*

Day (4 week class)

Weekend Sat/Sun (Butts Center Only)

Internship (need advisor approval)

Attach proof of DOT Physical*

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 25 MB.

Attach copy of CDL Permit*

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 25 MB.

Attach copy of *Updated* MVR*

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 25 MB.

By providing my digital signature below, I agree that I have provided the required documents and I agree/also understand:

By being accepted to Southern Crescent, it does not guarantee me acceptance to the CDL program.
If all of my documents are not included with my application, it will be considered null and void.
I have met the general Admissions requirements.
I will need to apply for FAFSA if I want Financial Aid to help cover all or part the program cost if I am selected into the program.
Only selected CDL program candidates will be contacted.
I further understand that I if am selected for the CDL program, I must pass the drug screen given at the mandatory CDL orientation before the first day of class.
I also understand that if I am NOT selected for the CDL program, I must reapply with a new admissions application and CDL program application for the desired semester you wish to enter.

Digital Signature (First-Name Last-Name)

Signature Date

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