---

Name ________________________________ Social Security Number ____________
(Last) (First)


Address _______________________________________________________________
(Street) (Town) (State) (Zip Code)


Home Phone _______________ Business Phone_______________ E-mail__________


If you are not currently enrolled at Suffolk:

High School attended_____________________________ Graduation Date ________


High School average______ Class Rank ______ of ______ students


Highest level of math completed ________ Which campus will you attend?________


Will you attend full-time or part-time? ___________ Day or evening? _______


Tentative curriculum choice _______________


Advanced Placement course taken ___________________________


What was your score on one or both of the standard college admissions tests?

ACT______ SAT______ ______
verbal math

If you are currently enrolled at Suffolk:

Campus _____________ Curriculum _____________ Cumulative GPA __________

Full-time or part-time? _____________ Day or evening? _____________

Have you completed EG11? _________ If so, grade received __________

Scholarships:

The Honors Program awards a number of scholarships annually. All students who are accepted into the Honors Program are automatically considered. The sole criteria for all Honors scholarships is academic merit.

How to apply to the Honors Program:

Complete this application and return it to the appropriate campus coordinator.

Submit a letter of recommendation from a teacher, guidance counselor or other person familiar with your academic potential.

Enclose a copy of your high school transcript, SAT or ACT reports and transcripts of any previous college coursework

Include an essay of approximately 500 words that gives a perspective on you as both a student and individual. The topic is open but the essay should be reflective of your best writing ability.



Send your Honors Program application and materials to the appropriate campus office:

Ammerman Campus Albin J. Cofone College Honors Coordinator Suffolk Community College 533 College Road Selden, NY 11784 (631) 451-4778

Eastern Campus Cheryl Coffey Campus Honors Coordinato Suffolk Community College Speonk-Riverhead Road Riverhead, NY 11901 (631) 548-2578

Western Campus Nancy Penncavage Campus Honors Coordinatorr Suffolk Community College Crooked Hill Road Brentwood, NY 11717 (631) 851- 6538

PLEASE NOTE: The Honors Program application is not an application for admission
to Suffolk. That application must be filed separately.