Grossmont Justice Scholars Interest Form

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Thank you for your interest in our program!

Grossmont Justice Scholars is a program supporting formerly incarcerated students on their academic journey through a variety of supportive services. To learn more about our program or to join, please fill out this form and we will be in contact with you soon.

Full Name (Last, First) *

Phone Number

Email address *

Grossmont College Student ID# (you may state "don't have one" if you are not a student yet): *

Have you ever been incarcerated? *

Yes

What is your major or career field of interest? *

Have you attended college before? *

Yes

What resources are you looking for at the moment: *

Getting Started: College Application and Registration Assistance

Academic and Career Counseling (figuring out major and classes needed)

Financial Aid Application Assistance and Scholarships

Connection to other On-Campus Programs & Resources (ARC, Tutoring, CalWORKs, etc)

Food, Housing and other Basic Needs Resources

Employment Resources

Record Clearance Resources

Other:

Required

Preferred way to contact you *

Phone

Text

Other:

Required

How did you hear about Grossmont Justice Scholars? *

Grossmont College Counselor or Professor

Las Colinas Detention and Reentry Center

Classmate

Friend

Grossmont College Website or Social Media

CalWORKs Program

EOPS Program

Other:

Required

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