Admi 5 Application

Please complete the request form below for verification of completion.

ADMI 5 Form - Huntington Campus

Name(Required)
Address(Required)

By typing my name and date below, I acknowledge that I am electronically applying for ADMI 5 status:
MM slash DD slash YYYY

Huntington Campus
Education Building Room 220
One John Marshall Drive
Huntington, WV 25755
Phone: 304-696-3131

South Charleston Campus
100 Angus E. Peyton Drive
South Charleston, WV 25303
Phone: 304-746-1992