JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Early Arrival 2023 Program Application
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Do you have preferred pronouns? If so, please indicate below.
Your answer
Email Address
*
Your answer
Telephone number?
*
Your answer
Please select the answer that best describes how you self-identify:
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic, Latino or Spanish Origins
Middle Eastern or North African
White
Multiethnic
Prefer not to disclose
Other:
Required
The Early Arrival program begins on
Tuesday August 1
and ends on
Wednesday August 2
. I am confirming a willingness to participate in both days on Lee Main Campus:
*
Confirm; I will be present both days
Cannot Confirm; I'm not sure I can attend both days
Required
If you are unable to attend a session, but would like the option to participate, please briefly indicate the nature of the schedule conflict.
Your answer
What are your transportation needs (only choose ONE)?
*
I have my own transportation
I do not have transportation and will need help getting to campus for this program
Other:
Required
Which academic program are you planning to study or are currently studying here at CCCC? Ex: Business Administration, Criminal Justice Technology, or Unsure
*
Your answer
Short Answer Question: What do you hope to learn from participation in this program?
*
Your answer
Thank you for submitting the Early Arrival 2023 Program Application. For questions, please contact RaShaunda Ashford at rashf482@cccc.edu or call 919-777-7711.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CCCC.EDU.
Report Abuse
Forms
