Home Finger Lakes School of Acupuncture and Oriental Medicine School of Applied Clinical Nutrition

Online Application: Part I
Please Note: * Asterisks identify required fields.
Academic Program
Program Applying For: *
How did you first hear of NYCC?
Personal Information
First Name (Legal) *
Middle Name
Last Name (Legal) *
Maiden or Other Previous Name
Email Address *
Country of Birth
Are you a US Citizen? * (If No, Please specify Country and Visa Type below)
Country of Citizenship
Type of Visa
Native Language *
Have you ever been convicted of, pled guilty to, or forfeited bail for any criminal conduct under law or ordinance, excluding minor traffic violations? If yes, please fully explain circumstances in a separate email to your Admissions Counselor.
Current Address
Use as Mailing Address
Street *
City *
State *
Zip *
Country (If Other than USA)
Permanent Address (if different from Current Address)
Use as Mailing Address
Country (If Other than USA)
Telephone Contact Information
Work Phone Number
Home Phone Number
Cell Phone Number
Preferred method of Communication
Diversity Information
Answers to these questions are solicited voluntarily, and will not be used in evaluating candidates for admission.  We appreciate your cooperation in providing this information

Please note: Although the social security number and date of birth information marked with ** are optional, not entering this information may delay financial aid processing or receipt of necessary tax documents.
Date of Birth (mm/dd/yyyy) **
Social Security # **
Marital Status
Number of Dependents
Ethnic Origin (choose 1)
Is there any disability in your general health (including speech and hearing) which might interfere with your studies or classroom attendance?
If yes, please describe your disability in 50 characters or less.