Student Support Services Prospective Student Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students wishing to participate in the Student Support Services program must complete this form, and if you are eligible, we will contact you for your intake interview. For additional services and information, contact the Student Support Services office at 339.4420 or 800.447.4091, ext—4420, or stop by the offices located on the lower level of Oaks Hall.

Preferred Name, First and Last *

Phone Number *

Email *

Major at SCC

SCC Student ID

Did your mother or father get a degree from a university? *

Yes

Are you receiving Financial Aid? *

Yes

Do you have a documented disability or utilize disability services at SCC ? *

Yes

Is this your first or second semester at SCC? *

Yes

Do you have a college degree? *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Southwestern Community College. Report Abuse

Forms