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Remote Enrollment Support
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Email
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Your email
Name
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Your answer
Middle Name
Your answer
Last Name
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Your answer
Pronouns
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He/His
She/Her
They/Their
Other:
Do you have access to Zoom or Google Hangouts?
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Yes
No
Date of Birth
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MM
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DD
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YYYY
Phone Number
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Your answer
Have you taken any courses for college credit before?
*
Yes
No
Not Sure
Have you completed a Financial Aid Application (FAFSA or California Dream Act)?
*
Yes
No
I am interested in getting more information on how to join the following programs:
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DSPS - Programs & Services for Students with Disabilities (including students with IEPs & 504 plans)
EOPS/CARE - Extended Opportunity Program & Services for full-time, low income students
CalWORKS - A program for student parents who receive federal aid
NextUP - A program for current and former foster youth
UMOJA - Learning community committed to the success & growth of African/African American & other students
MESA - Mathematics Engineering Science Achievement
Veterans Services - Provides assistance to veterans & eligible dependents of veterans
CTE - Career Technical Education
Puente Program Learning Community - Services and support for Latinx students
ACCESO Program - Services and support for Latinx students
Required
I identify my ethnicity as: (Select all that apply)
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Asian or Pacific Islander
Black/African
Caucasian
Hispanic/Latinx
Native American
Prefer not to answer
Other:
Required
Have you ever participated in CoA Career Discovery Day?
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Yes
No
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