Inclusive Higher Education Application

Choose the campus that is right for you!

The Inclusive Higher Education Program is now being offered at two locations: Nassau Community College and Queensborough Community College. Both programs offer a 5-day/week, comprehensive post-secondary experience. See brochure for additional details.

Before beginning the application process, please review the differences between our two campus offerings. Select which program(s) you would like to apply to.

NASSAU COMMUNITY COLLEGE
1 Education Drive, Garden City, NY 11530

Diploma Requirements: HS Diploma, HSE only
Program Fee: $1,000/semester in addition to tuition
Upon Completion: Certificate of Completion issued by The Viscardi Center.
Financial Aid: Students are not eligible for federal financial aid.

QUEENSBOROUGH COMMUNITY COLLEGE
222-05 56th Avenue, Bayside, NY 11364

Diploma Requirements: HS Diploma, HSE, CDOS, SACS
Program Fee: $0, tuition only
Upon Completion: CUNY Unlimited Credential in Academic and Career Studies issued by the college.
Financial Aid: Students may be eligible for federal financial aid (PELL).

Which program(s) are you applying for?(Required)

Nassau Community College

Queensborough Community College

Contact & Residency Information

Student's Name(Required)

First Middle Last

Social Security Number (last 4 digits)(Required)

Sex(Required)

Male

Female

Other

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Length of time at above address(Required)

Years/Months

Length of time in New York State(Required)

Years/Months

Mailing address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Phone Number(Required)

Cell Phone Number(Required)

Email Address (preferred)(Required)

Are you a U.S. citizen?(Required)

Yes

No

If you are not a U.S. citizen, you must provide the following information about your immigration:

Country of Birth

Status: Permanent Resident - Alien Registration #

Date of entry on card

Visa (specify type)

Date obtained

Expiration date

Personal Vision

Why do you want to go to college?(Required)

Tell us a little about yourself. What are some of your best qualities?(Required)

What are your goals and dreams in life?(Required)

What is your career goal?(Required)

Certification

All applicants must sign and date here.

Applicant Signature(Required)

Date

Guardian Signature(Required)

Date

NOTICE

Inclusive Higher Education (IHE) is designed to promote independence and participation in authentic college environments. As such, the program does not provide 1:1 supervision, personal aides, medical aides, or external advocates to accompany students during classes or program activities. Support is provided through IHE peer mentors in accordance with the program model. Due to these design parameters, the program may not be appropriate for students who require continuous 1:1 support to safely and successfully participate in academic or campus-based activities.

If a participant enrolls in 6 or more credits, proof of immunization will be required by the college.

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The Viscardi Center

Inclusive Higher Education

Choose the campus that is right for you!

Contact & Residency Information

If you are not a U.S. citizen, you must provide the following information about your immigration:

Education

Vaccination Notice:

Demographic Data Section (Optional)

Applicant Profile

Transition Status

Transportation

Academic Interests

Learning Style

Personal Vision

Certification

NOTICE

Interested in Learning More?

The Viscardi Center

Inclusive Higher Education

Choose the campus that is right for you!

Contact & Residency Information

If you are not a U.S. citizen, you must provide the following information about your immigration:

Education

Vaccination Notice:

Demographic Data Section (Optional)

Applicant Profile

Transition Status

Transportation

Academic Interests

Learning Style

Personal Vision

Certification

***NOTICE***

Interested in Learning More?

NOTICE