Montgomery County Community College – Alvernia University
Dual Admission Intent to Enroll Form
Montgomery County Community College and Alvernia University have established a Dual Admission
Program. Through this agreement, students will be guaranteed admission into a specified
baccalaureate degree program at Alvernia University provided they meet the requirements of the dual
admission agreement while enrolled at MCCC. Upon admission to MCCC, students enrolled in the
Dual Admission program will have access to take courses and utilize the facilities of both institutions,
and have access to coordinated academic advising between MCCC and Alvernia University.
Completion of this Dual Admission Intent to Enroll Form entities you to be admitted into a Bachelor's
degree program with upperclassman status at Alvernia University provided that the student is admitted
to Montgomery County Community College and enters into the MCCC-Alvernia Dual Admission
agreement prior to first semester enrollment at MCCC;
Graduates from MCCC in an Associate of Applied Science, Associate of Arts, or Associate of Science
degree program with a minimum cumulative GPA of 2.00;
Must be in good academic and social standing at the time of application for full relocation to Alvernia;
Completes the Dual Admission Intent to Enroll Form in accordance with Alvernia University
admission requirements. Students applying to the undergraduate day program must submit this form at
least one semester prior to the intended start date at Alvernia. (Students applying to the non-
traditional/evening program should apply at least one session (7 weeks) prior to their intended start
date at Alvernia.);
Submits official final transcripts from all secondary, post-secondary, and military coursework at the
time of application for transfer.
*Upon completion of MCCC and successful transition to Alvernia University, the student will then be
bound by Alvernia University student policies and responsibilities, including tuition, financial
assistance, housing, activities, policies, procedures, codes of conduct, and other University
requirements.
Student Information:
First Name: __________________________ Last Name: ______________________________
Date of Birth: ________________________ Email: __________________________________
Address: ____________________________ City: ___________________________________
State: Zip Code: _______________________________
Phone (Home): _______________________ (Cell): __________________________________
Enrollment Information
Term of Enrollment at MCCC:
Year: ________ Semester Fall Spring Summer
Expected Term of Relocation to Alvernia University:
Year: ________ Semester Fall Spring Summer
Intended Status at Alvernia University: Full Time Part Time
Intended Major at Alvernia University (please indicate one)
Day Program Adult Education Program (Evening)
□ Addictions & Mental Health □ Addictions & Mental Health
□ Biochemistry □ Accounting
□ Biology □ Finance
□ Biology –Medical Laboratory Science □ Healthcare Administration
□ Business □ Healthcare Science
□ *Accounting □ Human Resource Management
□ *Economics □ Management
□ *Finance □ Marketing
□ *Healthcare Administration □ Communication
□ *Human Resource Management □ Criminal Justice Administration
□ *Management □ Liberal Studies
□ *Marketing □ RN-BSN
□ *Sport Management □ Social Work
□ Chemistry
□ Communication
□ Computer Science Online Program
□ Criminal Justice Administration □ Addictions & Mental Health
□ Digital Media Marketing □ Communication
□ English □ Criminal Justice Administration
□ Environmental Science □ Healthcare Administration
□ Forensic Science □ Healthcare Science
□ Liberal Studies □ Management
□ General Science □ Psychology
□ Healthcare Science □ RN-BSN
□ History
□ Liberal Studies
□ Mathematics
□ Philosophy
□ Political Science
□ Psychology
□ Social Work
□ Theatre
□ Theology
As a participant in the Dual Admission Program, I authorize MCCC and Alvernia University to
exchange necessary information, as needed, to facilitate my transfer to Alvernia University. I have read
and understand the conditions of the Dual Admission Program as stated above and in the MCCC and
Alvernia University Dual Admission Partnership Agreement Fact Sheet. I also understand that my
MCCC and Alvernia University "Dual Admission Intent to Enroll Form" can be voided by me, the
student, at any time with written notification to MCCC's Office of Admissions and Records and
Alvernia University's Undergraduate Admissions Office or Graduate and Adult Education Admissions
Office.
Signature: __________________________________
Date: __________________
MCCC Transfer Contact Information: 215-641-6551 | [email protected]
Alvernia Transfer Coordinator: Bret Krotee | 610.796.5510 | [email protected]
