Admissions & Enrollment Information - Hartnell College!!

* Office of Admissions and Records * 156 Homestead Avenue * Salinas , CA 93901 * Telephone : (831) 755-6711 * Fax: (831) 759-6014
PLEASE ANSWER ALL QUESTIONS AND PRINT CLEARLY. Incomplete applications cannot be processed.
LEGAL NAME: Do not use nicknames Mr.
Last Name First Name Middle Name (Names previously used)
PERMANENT MAILING ADDRESS
SOCIAL SECURITY NUMBER
--
Month Day Year
(B.) African/American
(N.) Native-American/Alaskan
(AM) Asian/Cambodian
(AC) Asian/Chinese
(AJ) Asian/Japanese
(AK) Asian/Korean
Gender:
Semester/Yr: Entered by: Date:
STEP 1
Hartnell College APPLICATION FOR ADMISSION
Male
Ms. Mrs. Dr.
P.O.Box/Number/Street/Apt.No. City/State Zip Code County or Country
Home Telephone
Area Code Number
BIRTHDATE
Ethnic Background (choose only one)
Admit Status: (check one)
--
(FT) First Time Student At Any College
(TRAN) First Time Transfer Student to Hartnell
Educational Goal
(Check one item which best identifies your goals)
BWAA
BWOAA
AAWOT
Obtain a bachelor's degree after
completing an associate's degree
Obtain a bachelor's degree without
completing an associate's degree
Obtain a two-years associate's degree
without transfer
NCCW Move from Noncredit coursework to
Credit coursework
Citizenship (Immigration Status): (check one)
(1) U.S. Citizen
(AL) Asian/Laotian
(AV) Asian/Vietnamese
(AX) Asian/Other
(F.) Filipino
(HR) Hispanic/Cent.American
(HM) Hispanic/Mex-American
NOTE TO ALL STUDENTS: You are hereby informed that you cannot be required to
provide a Social Security Number (SSN). The SSN is used by colleges as a common
method to identify students records, and is authorized by the state chancellor's office
of California Community College system which uses them for evaluation of educational
programs and services. If you refuse to provide a SSN, a local student I.D. number
will be assigned. Students who do not have a Social Security Number on file will be
required to produce their local student I.D. number for all current and future services.
Also Public Law 104-208 Known as the Solomon Amendment requires Hartnell
College to provide student directory information to the Department of Defense, including Military
recruiters, upon request. Dependents of service-connected disabled or service-connected deceased
veterans may be eligibile for a waiver of fees. Please contact the Veteran's Office on campus or local
County Veteran Service Office for assistance.
(HS) Hispanic/S.American
(HX) Hispanic Other
(O.) Other Non-White
(PG) Pacific Islander/Guam
(PH) Pacific Islander/Hawaii
(PS) Pacific Islander/Samoan
(PX) Pacific Islander/Other
(AI) Asian/Indian
(W.) White/Non-Hispanic
(X.) Declined to State
Female ADMISSION FOR (check only 1 semester): Major/Academic Program
Fall
Spring
Summer
VAWOT
VOCCT
CAR
JOB
UPJOB
(2) Permanent Resident-INS# A Issue Date:
(3) Temporary Resident-INS# A Issue Date:
PLEASE USE BLACK OR BLUE INK PENS ONLY
E-Mail Address
20
20
20
(RTS) Returning Transfer Student
(RFS) Returning Former Student
(CT) Continuing Student
Obtain a two-year vocational
degree without transfer
Earn a vocational certificate
without transfer
Discover/formulate career
interest, plans, goals
Prepare for a new career
(acquire job skills)
Advance in current job/career
(update job skills)
(4) Refugee/Asylee
(5) Student Visa F-1/M-1
(6) Other Status
(7) Visitor
(8) Amnesty
(Please complete both sides of form)
Apply on line: www.hartnell.edu
LIC
EDDEV
BSSK
HSDIP
4YEAR
UND
(see back page for Code List)
Please enter appropriate code:
(HS) High School Student
(K8) K-8 Student
Maintain certificate or license
(e.g. Nursing)
Educational development
(intellectual, cultural)
Improve basic skill in
English, Reading or Math
Complete credits for High
School diploma or GED
Is English your native language?
Yes (EN)
Other (OT)
*
No, Spanish (SP)
4-year College student who needs to
meet a 4-year College Rqmt.
Undecided on Goal