Personal Information
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First Name is a required field! |
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Last Name is a required field! |
| * | | StreetAddress is a required field! |
| * | | City, State, ZipAddress cont. is a required field! |
| * | | (XXX)XXX-XXXXPrimary Telephone Number is a required field! |
| * | | (XXX)XXX-XXXXSecondary Telephone Number is a required field! |
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Email is a required field! |
| | Campus Email, Work Email, etc.Alternate Email Address is a required field! |
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Gender is a required field! |
| * | | MM/DD/YYYYDate of Birth is a required field! |
Academic Information
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Academic Standing Upon Entering CSUSM is a required field! |
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Overall GPA is a required field! |
| * | | (e.g. Fall 2009)Semester and Year Entering CSUSM is a required field! |
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What Are You Interested in Studying at CSUSM? is a required field! |
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What is Your Career Interest/Goal? is a required field! |
Transfer Student Information (If Applicable)
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What College Are You Transferring From? is a required field! |
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Number of Credit Hours Earned is a required field! |
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Area of Study is a required field! |
Housing Information
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Are You Planning on Living on Campus? is a required field! |
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If "Yes" Have You Completed the On-Campus Housing Application? (Refer to College Application Steps) is a required field! |
Employment Information
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| | Employer, Description of Work, Dates of Employment, Hours Per WeekPlease List Work Experience During the Past 3 Years (Beginning With the Job You Hold or Held Most Recently). is a required field! |
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If You Are Currently Working, Please List the Number of Hours Per Week. is a required field! |
Foster Care Information (You Are Required to Submit a Foster Care Eligibility Certification Form to ACE Scholars Services by January 15th)
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Were You in Foster Care on or After Your 13th Birthday? is a required field! |
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Did You Remain in Foster Care For More Than 2 Years following your 13th Birthday? is a required field! |
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Were You Emancipated From Foster Care is a required field! |
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Are You Under The Age of 28? is a required field! |
| | Years and MonthsIn Total, How Long Were You or Have You Been in Foster Care? is a required field! |
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Age You Entered Foster Care? is a required field! |
| | MM/YYYYWhen Were You or When Will You Be Emancipated? is a required field! |
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Number of Placements is a required field! |
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How Often Do You Have Contact With Biological Family? is a required field! |
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Number of Siblings is a required field! |
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Sibling Ages is a required field! |
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County in Which You Received Foster Care Services is a required field! |
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Current Medical Coverage (Mark All That Apply) is a required field! |
Previous Schools Attended
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Number of Elementary Schools Attended is a required field! |
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Number of Middle or Jr. High Schools Attended is a required field! |
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Number of High Schools Attended is a required field! |
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High School You Graduated From or Are Currently Attending is a required field! |
Please List at Least One contact Person Who is Assisting You in the College Admission Process.
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Name of First Contact is a required field! |
| * | | (XXX)-XXX-XXXXPhone Number of First Contact is a required field! |
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Email of First Contact is a required field! |
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Relationship of First Contact is a required field! |
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If "Other" Please Specify for First Contact is a required field! |
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Name of Second Contact is a required field! |
| | (XXX) XXX-XXXXPhone Number of Second Contact is a required field! |
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Email of Second Contact is a required field! |
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Relationship of Second Contact is a required field! |
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If "Other" Please Specify for Second Contact is a required field! |
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Name of Third Contact is a required field! |
| | (XXX) XXX-XXXXPhone Number of Third Contact is a required field! |
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Email of Third Contact is a required field! |
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Relationship of Third Contact is a required field! |
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If "Other" Please Specify for Third Contact is a required field! |
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Tell Us About Some of Your Personal Interests, and Activities to Which You Have Committed a Significant Amount of Your Time and Energy. is a required field! |
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What Support Services (Other Than Financial Aid) Do You Foresee Needing During Your First Year at CSUSM? is a required field! |
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How Did You Hear About ACE Scholars Services at CSUSM? is a required field! |
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By Checking "Agree" I Attest The Information Is True and Accurate and Solely By Me. I Understand That Any False Statements Could Mean Expulsion From The Program And Possibly CSUSM. is a required field! |
| * | | MM/DD/YYYYDate is a required field! |
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