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CCHE Student Intake Form
Please provide the following information so CCHE can serve you better.
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Today's Date
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First and Last Name
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Your answer
Email
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Your answer
Phone number
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Mailing Address (include city, state, zip)
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Select the education you have completed:
GED
High School Diploma
Some College
Associate's Degree
Bachelor's Degree
Graduate Degree
Technical Training
Medical Training
Other:
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If you've attended higher education institutions, please name them here:
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If you've attended higher education institutions, please list your main fields of study:
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If you've attended higher education institutions, when did you attend?
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SELECT THE AREA WHERE CCHE CAN ASSIST:
Financial Aid (grants, scholarships, loans, FAFSA, etc.)
Finding and applying to colleges / researching programs / trainings
Researching online vs. in-person options
Help working with your school on concerns, questions and scheduling
Accessing my school transcripts
24 hour access to CCHE study room / technology
Proctored exams: scheduling and questions
Placement tests (ACT, SAT, Accuplacer, etc.)
Proof-reading, editing and formatting essays/papers
Finding a mentor or tutor
Computer / technical support
Resumé development / interview skills / job seeking
Other:
Additional notes or questions you'd like to add:
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