Application Form (Online)

Western Dakota Technical Institute requires that a $20 non-refundable application fee accompany the Application for Admission. Please send Check or Money Order to:

Admissions Office
Western Dakota Technical Institute
800 Mickelson Drive
Rapid City, SD 57703

Please call us at 605-394-4034 or 800-544-8765 if you have questions.

Personal Information

Please complete all sections of the form, if not applicable, please type "NA" in the appropriate blank

Last Name 
First Name
Middle Initial
Maiden Name
Social Security #:
Current Address: City:
State/Country: Zip:

Permanent Address: City:
State/Country: Zip:
Home Phone: Work Phone:

E-mail Address:

Name of Parent/Guardian:
Permanent Address: City:
State/Country: Zip:

Academic Program Information

Program you wish to Enter: (1st Choice)
Program you wish to Enter: (2nd Choice)
Program you wish to Enter: (3rd Choice)

Preferred Start Term:
Day Time or Evening:

Additional Information

Are you eligible for Veteran's Benefits? Yes No

Do you need information on Financial Aid? Yes No

Do you need information on Housing? Yes No

What is the name of your Home Town Newspaper?

Have you previously applied at Western Dakota Tech? Yes No

If so, when? What program?

High school: Date of Graduation:

If GED, list date: Location of Test Center:

Standardized Test (ACT/SAT): Score on ACT/SAT:

List any post-high school training or education (vocational/college/military). Request all transcripts to be sent to Western Dakota Tech.

Name of Institution:
Date Attended:
Program/Major:
Hours/Credits/Months:

Name of Institution:
Date Attended:
Program/Major:
Hours/Credits/Months: