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Contact Information

Legal First Name

Legal Last Name

High School Email Address

Confirm High School Email Address

Mobile Phone

Format: xxx-xxx-xxxx

Do not send text messages regarding my application

Date of Birth

When did you/will you earn a high school diploma or GED (HiSet)?

Home Address

Address Line 2

City

State/Province

ZIP/Postal Code

When do you plan to start your DMACC classes?

Account Information

• Minimum length of eight (8) characters • Upper or Lower-Case Letters (A, B, C …Z, a, b, c …z) • At least one numeral (0, 1, 2….9) • At least one non-alphanumeric “special characters”

Password

Confirm Password