NMTI Application

NMTI Application ID

Full Name(Required)

First Middle Last

Date of Birth(Required)

Gender(Required)

Contact No.(Required)

Confirm Contact No.(Required)

Email(Required)

Enter Email Confirm Email

Mailing Address

Island(Required)

Village (Saipan)(Required)

Village (Tinian)(Required)

Village (Rota)(Required)

Citizenship(Required)

US Citizen

Non-US

FSM

Ethnicity(Required)

Do you have any court records?(Required)

If yes, specify reason of court record

Education and Work History

Highest Degree Obtained(Required)

None

GED

High School Diploma

Other

Are you currently attending high school?(Required)

Yes

No

Are you employed?(Required)

Yes

No

Who is your employer?

Position

Hours

Emergency Contact

First Last

Relationship

Emergency No.

Certification(Required)

I certify that the information provided is true and correct to the best of my knowledge.

I hereby certify that the information contained in this application is true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any misrepresentation, falsification, or omission of information in this application or any document used to secure enrollment shall be grounds for rejection of this application, or immediate discharge if I am enrolled, regardless of the time elapsed before discovery,

Family Educational Rights & Privacy Act (FERPA)(Required)

Release: Northern Marianas Technical Institute may release any or all information listed above without my expressed permission

No Release: Northern Marianas Technical Institute shall not release any or all of the information listed above without my expressed permission

Notice to Students: This request form must be completed and renewed each fall, spring, and summer semester session if you do not wish NMTI to release directory information. I understand that under the Family Education Rights & Privacy Act, NMTI may release the following Directory Information about me to other persons without my permission. * Student's Name * Mailing Address * Telephone Number * Date and Place of Birth * Dates of Attendance * Certificate(s) Conferred * Registration Status * Field of Study

Education and Work History

Education and Work History

Emergency Contact