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23-24 Puente Program Student Interest Sheet
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Last Name
Your answer
First Name
Your answer
Middle Name
Your answer
MSJC Student ID Number
Your answer
MSJC Email Address
Your answer
Personal Email Address
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Choose
Male
Female
Other
Intended Major
Your answer
Mailing Address (include city, state, and zip code)
Your answer
Phone Number
Your answer
Describe your hobbies / talents (50 words)
Your answer
Ethnicity
Choose
Mexican / Mexican-American / Chicano
Puerto Rican / Puerto Rican-American
Salvadorean / Salvadorean-American
Nicaraguan / Nicaraguan-American
Other Latino
African - American / Black
American - Indian / Alaska Native
Chinese / Chinese - American
East Indian / Pakistani
Filipino / Filipino - American
Japanese / Japanese - American
Korean / Korean - American
Pacific Islander
Vietnamese / Vietnamese - American
Other Asian
White / Caucasian
Other
What campus do you plan on attending
Temecula (TVC)
San Jacinto (SJC)
Menifee (MVC)
High School Attended
Your answer
Do you plan to transfer to a 4 - year university?
Choose
Yes
No
Don't Know / Not Sure
Universities you are considering for transfer
Your answer
Are you working while attending school
Yes
No
Unsure
Clear selection
If yes, how many hours per week
Your answer
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