When are you interested in starting?
Legal First Name
Legal Last Name
Do you have any previous names?
Please list all previous names that may appear on a transcript.
Date of Birth
City / Town
This certification is only valid for the State of Connecticut
Have you served in the U.S. Military or are you a military spouse?
Select Military Branch
Select a Military Status
Please select your Gender
Please indicate how you identify yourself (choose one or more)
You are required to request official transcripts from all of the Colleges/Universities you attended.
Are you currently employed?
If you do not see your employer listed in the drop down, please select Employer Not Listed.
Please specify employer and location
As part of the ARC-ECE Application process, we requite the following 2 documents in either a Word or PDF format.
The name of these documents should include the first initial of your first name followed by your last name. For Example: Jack Smith would be JSmith_experience.docx and JSmith_reasons.docx
Email both of these documents as an attachment to email@example.com
These documents must be provided with in the next two business days.
By submitting this form, I confirm that the information provided on this form is accurate and complete, and subject to the policies and procedures of Charter Oak State College and the Connecticut Board of Regents.