CAMP Info Request Form

CAMP Info Request

Do you think you may qualify for the College Assistance Migrant Program? Please fill out the below information and an advisor will be in contact with you to discuss eligibility.

*First Name		First Name is a required field!
*Last Name		Last Name is a required field!
*Address		Address, City, State, Zip. Address is a required field!
*Home Phone		(XXX) XXX-XXXX Home Phone is a required field!
Cell Phone		(XXX) XXX-XXXX Cell Phone is a required field!
*Email		Email is a required field!
*High School		High School is a required field!
*What is your current school grade?		What is your current school grade? is a required field!
*Graduation Date		Expected H.S. Grad Date (XX/XX/XX) Graduation Date is a required field!
*Date of Birth		(XX/XX/XX) Date of Birth is a required field!
*Are you a U.S. Citizen or Legal Resident of the U.S.?		Are you a U.S. Citizen or Legal Resident of the U.S.? is a required field!
*Are you a current or former participant of the Migrant Education Program?		Are you a current or former participant of the Migrant Education Program? is a required field!
Have you or your parents worked in seasonal and/or migrant farmwork for at least 75 days in the past 24 months?		Agricultural Activities: Crops,dairy products, poultry or livestock, fish farms, cultivation of plants and trees. Have you or your parents worked in seasonal and/or migrant farmwork for at least 75 days in the past 24 months? is a required field!
*Are you interested in attending CSUSM?		Are you interested in attending CSUSM? is a required field!
*Is CSUSM your first choice?		Is CSUSM your first choice? is a required field!
Comments/Questions:		Please enter other schools you are applying to in comments section. Comments/Questions: is a required field!
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