Johnstown Regional Police Academy
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Former / Maiden Name
Note: Please provide an email address that you will use to Receive Your Username, Activate Your Account, Change/Reset Your Password, and to use for Multi-Factor Authentication (MFA) on your college account.
Confirm Email Address
How long have you lived at this address?
If less than one year, enter prior county and state of residence:
Primary Phone Number
Note: Please provide a mobile number that you will use to Activate Your Account, Change/Reset Your Password, and to use for Multi-Factor Authentication (MFA) on your college account.
Cellular Phone Number
Work Phone Number
The completion of the following information is voluntary and optional. It will be used to comply with Federal reporting and has no effect on admission to the College. Pennsylvania Highlands Community College is committed to the principle of equal education for all students without regard to race, national origin, marital status, creed, gender, age, or handicap.
Are you the first generation in your family to attend college?
Date of Birth
Social Security Number
Please Note: Social Security and Date of Birth is voluntary information; however, if you intend on utilizing Financial Aid, both your Social Security Number and Date of Birth are necessary in order to process any aid awarded, inclusive of scholarships, grants, and loans.
Country of Citizenship
Note: If you are not a U.S. citizen or permanent resident, you will be required to submit a copy of your VISA to the Admissions Office.
Race (Choose 1 or more)
Are you currently a dislocated worker?
Is English your second language?
Are you currently a homeless individual?
Are you currently in, or have aged out of foster care?
Are you 18 or younger and have a parent that is active duty in the military?
Note: Police Academy students can apply for the following financial aid programs:
Do you Plan on using Financial Aid for this Program?
Have you submitted the Free Application for Financial Aid (FAFSA)?
I plan to enroll in the following term
I plan to enroll in the following year
What is your Career Goal?
High School Information
Name of High School
Did you receive a High School Diploma?
Year of high school graduation or anticipated graduation year
I have not received a High School Diploma because
GED Information - Complete if you did not graduate from High School
Have you earned a GED (General Education Diploma)?
Date GED Received
CTC/Vo-Tech School Information
Note: Please complete the following information if you attended a Career and Technical Center (CTC) or a Vo-Tech School.
Name of CTC/Vo-Tech School
Did you receive a Certificate?
(IF YES) Year of CTC/Vo-Tech school completion
(IF NO) I have not received a Certificate because
College/Trade School Information
Please list in chronological order any colleges or technical schools that you have attended.
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State of Institution
Name of Institution
Program of Study/Major
Year of Graduation
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Emergency Contact Information
Name of Person to Contact in Case of an Emergency
Contact Phone Number
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