Community College Black Bear Advantage Participation Form

Black Bear Advantage

This form is for students enrolled at a Maine Community College who would like to participate in the UMaine/UMaine Machias Black Bear Advantage program. There is no application fee. To be approved, students must meet the following criteria:

Be enrolled full-time at a Maine Community College in a degree program that has a current transfer articulation agreement with the University of Maine/the University of Maine at Machias.
Have previously applied to and been offered admission to the University of Maine/University of Maine at Machias program that is articulated with their community college program (or have previous UMaine/UMaine Machias application materials that show the student meets the admission criteria for the UMaine/UMaine Machias academic program they want to participate in.)*
Agree to enroll in one course at UMaine/UMaine Machias for each semester they are in the Black Bear Advantage program. This course will be chosen in conjunction with the student's community college advisor and their UMaine/UMaine Machias academic advisor. It can be taken remotely or on the UMaine/UMaine Machias campus.

*Students who have not previously applied to UMaine/UMaine Machias may apply to UMaine/UMaine Machias and if offered admission, they can withdraw their UMaine/UMaine Machias application, remain at their community college, and submit the Black Bear Advantage Participation form.

General Information

First Name

Middle Name

Last Name

Preferred Name

Name used on previous application (if different from current)

UMaine Student ID (7 digits)

Social Security #

Telephone

Email Address

Re-Enter Email Address

Date of Birth

Month

Day

Year

Address

Street

Apt # (if applicable)

City

State

Zip

Country

Is your mailing address different from your permanent address?

YesNo

Mailing Street

Apt #

Mailing City

Mailing State

Mailing Zip

Country

Previous UMaine Application

Semester Previously Applied to the University of Maine:

FallSpring

Year Previously Applied to the University of Maine:

Signature

Please contact your former high school and request that they submit an official final high school transcript, showing your date of high school graduation, to the University of Maine. If you have completed one or more semesters at your Community College, please have that transcript sent to UMaine. Please request materials to be sent digitally to edocs@maine.edu, or mailed to:

University Processing Center

University of Maine System

PO Box 412

Bangor, ME 04402-0412

My signature below verifies that the information I have reported on this application is complete and factually correct and that I give permission for the Office of Admission to request my academic record electronically.

Student Signature

Date

Application materials received in the Office of Admission become the property of the University of Maine System and the university to which the student is seeking enrollment. University policy requires these records be retained and not returned to the applicant nor forwarded or released to a third party outside the University of Maine System.

Maine State Law requires that all full-time and degree-seeking part-time students born after 1956 show proof of adequate immunization against measles (rubeola), rubella, diphtheria, and tetanus. Students will be notified by the campus they plan to attend concerning required documentation.

For your information:

AMERICANS WITH DISABILITIES ACT: University of Maine System universities are prepared to assist students with disabilities. If you have a disability and would appreciate help in eliminating a barrier to your admission or subsequent campus experience, please write or call the Admission Office at the university to which you are applying. All information disclosed will be considered confidential. Should you require accommodations to complete this application, contact the Admission Office to which you are applying.

CLERY ACT: The Clery Act requires universities to disclose three year statistics regarding campus crime, including public property within, or immediately adjacent to and accessible from the campus. This report includes our policies for campus security, such as those concerning alcohol and drug use, crime prevention, the reporting of crimes, sexual assault, and other matters. You can obtain a copy of this report by contacting each of the campuses to which you are applying. The report is available on each campus web site.

EQUAL OPPORTUNITY POLICY: In complying with the letter and spirit of applicable laws and pursuing its own goals of diversity, the University of Maine System does not discriminate on the grounds of race, color, religion, sex, sexual orientation, transgender status, gender, gender identity or expression, ethnicity, national origin, citizenship status, familial status, ancestry, age, disability physical or mental, genetic information, or veterans or military status in employment, education, and all other programs and activities. The University provides reasonable accommodations to qualified individuals with disabilities upon request. The following person has been designated to handle inquiries regarding nondiscrimination policies: Director of Equal Opportunity, 5713 Chadbourne Hall, Room 412, University of Maine, Orono, ME 04469-5713, 207-581-1226, TTY 711 (Maine Relay System). Questions and complaints about discrimination in any area of the University should be directed to the campus Equal Opportunity Director; for contact information visit https://umaine.edu/eo/.

The University of Maine System complies with Title IX of the Education Amendments (1972), Title VI of the Civil Rights Act (1964), Section 504 of the Rehabilitation Act (1973), and the Americans with Disabilities Act of 1990.