My College Now - Account & Registration Request

Legal First Name*

Legal Last Name*

Middle Name or Initial

Chosen First Name if different than Legal First Name

High School

High School Graduation Year*

Cell Phone Number (10-digit)*

10 digits (i.e. 5551231234). A verification code will be sent to this number

Email*

Confirm Email*

Password*

Please choose a strong password, with min. 8 characters, at least 1 digit and 1 uppercase letter

Retype Password*

Date of Birth*

Enter date as mm/dd/yyyy

Gender*

Gender pronoun

Gender identity

Parent/Guardian First Name

Parent/Guardian Last Name

Parent Email

What is the highest level of education that parent/guardian completed?*

Mailing Address Line 1*

Address Line 2

City*

State*

Zip Code*

Ethnicity*

Hispanic/Latino

Non-Hispanic/Latino

Prefer not to answer

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:*

American Indian/Alaska Native

Asian

Black/African American

Native Hawaiian/Other Pacific Islander

White

Prefer not to answer

Please affirm the following before you submit your application.

I understand that once my application has been submitted it may not be altered in anyway.
I certify that all of the information submitted in the application is my own work, factually true, and honestly presented. I authorize all schools attended to release all requested records and authorize review of my application. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation or expulsion, should the information I certified be false.
I understand an offer of admission is conditional, pending approval from your designated school district.
I hereby consent to receive electronic communications (email and texts) from Western Iowa Tech Community College and an any time can opt out.
Your signature authorizes Western Iowa Tech Community College to release confidential records regarding all grades and credits to your high school.

Please review your application carefully to ensure you entered your information correctly. This information will be used to create a PERMANENT college transcript.*

Western Iowa Tech Community College

College Now Portal