C.L.A.S.E. Transfer Mentor Program: Mentee Interest Form

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The Chicano/a - Latino/a, Access, Success and Empowerment (CLASE) Transfer Mentor Program's mission is to help Chicano/a, Latino/a students have access to all the right resources that will help them reach their highest potential as individuals, students, and members of their community. We will support, empower, and allow growth among our students. We know the value of obtaining a higher education which is why our goal is to encourage our students to transfer to a 4-year institution. Please fill out this interest form to take advantage of the benefits CLASE offers you!

Today's Date:

YYYY

First Name:

Last Name:

Student ID Number:

Units Completed:

0-15

15-30

30-45

45-60

Over 60

Clear selection

Major:

Personal Email:

Cell Number or Home:

Are you Chicano/a, Latino/a?

Yes

Clear selection

I'm interested in the following:

Transfer Center Workshops (Online UC/CSU applications, UC Personal Statements, TAG, other)

Organized campus tours

Help from an experienced student

Community Service

TAG Program (UC Transfer Admission Guarantee)

College Fairs

Interact/Meet with other peers

ADT (Admissions Degree for Transfer

Attend Cultural Events

Other:

Are you an EOPS student?

Yes

Clear selection

Did you qualify for the BOG Waiver/ California College Promise Grant?

YES

Unsure

Clear selection

Any other comments?

Submit

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