Legal First Name
Legal Last Name
Date of Birth
List any previous Last Names
Are you a US citizen or Permanent Resident?
Alien Registration Number
Race (Choose one or more)Regardless of your answer to the prior question, please indicate your race.
Have you ever been convicted of a felony?
Please provide an explanation of the conviction.
Address Line 1
Address Line 2
Primary Phone Number
Phone Number Type
Confirm Email Address
What year do you plan to begin your studies?
What term do you plan to begin your studies?
What program are you interested in?
How did you hear about Cox College?
If you have worked with a member of our Admissions team, please specify who.
Did you attend High School or complete your GED?
In which state did you complete your GED?
State of High School or College/University
Name of High School or College/University
City and State of Institution
Have you ever been dismissed or suspended from any college?
Please provide an explanation of the dismissal or suspension.
*Hidden Test Part Count
Test Part 1
Test Part 2
Test Part 3
Test Part 4
Test Part 5
Test Part 6
Military Service Information
Are you a Veteran?
Branch of Service
Are you on Active Duty?
Are you in the National Guard?
Are you in ROTC?
Are you in the Reserves?
Are you the spouse or dependent of a Veteran or Active Duty service member?
The statements I have made in this application are correct to the best of my knowledge. I understand that any misrepresentation or omission of facts requested in this application is cause for disqualification for admission or for dismissal from Cox College. If admitted, I agree to conform to all rules and regulations of Cox College. I also agree to give Cox College permission to share the results of the background check and immunization records with clinical agencies.
Cox College does not discriminate on the basis of race, color, national origin, religion, disability, age, veteran status, political affiliation, sex, sexual orientation, gender identity, pregnancy, marital status, or any other basis protected by law in its programs or activities.
Any person having concerns with respect to rights; questions about reasonable accommodations; the existence and location of services, activities, and facilities that are accessible to and usable by persons with disabilities; or needs other information should contact the Vice President of Student Affairs at Cox College, 1423 N. Jefferson Ave., Springfield, MO 65802; phone number 417-269-3401.
This application requires a $50 application fee due at the time of submission via credit card. If you have been provided a waiver code, you may enter the waiver code in the box below in place of paying the application fee.
$50 Admission Application Fee