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SDCCD Application Processing

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College and Term

College *

Semester *

Program of Study *

Educational Goal *

Student Information

Last Name *

First Name *

Middle Name

Suffix

Previous Name

Other Last Name

Other First Name

Other Middle

Permanent Address *

Apt, suite, etc.

Country

City

State

Zip code

Mailing same as Permanent?

Yes

Mailing Address

Apt, suite, etc.

Country

City

State

Zip code

Main Phone

Text Authorization

Yes

Secondary Phone

Text Authorization

Yes

Email *

SSN/ITIN

Type

SSN

ITIN

Birth Date *

Gender

Male

Female

Martial Status

Dependent Status

Dependent

Independent

Parent/Guardian 1 Education

Parent/Guardian 2 Education

Hispanic

Not Hispanic

Decline to State

Ethnicity

Asian: Indian

Asian: Chinese

Asian: Japanese

Asian: Korean

Asian: Laotian

Asian: Cambodian

Asian: Vietnamese

Asian: Filipino

Asian: Other

Black of African American

American Indian/Alaskan Native

Pacific Islander: Guamanian

Pacific Islander: Hawaiian

Pacific Islander: Samoan

Pacific Islander: Other

White

Mexican, Mexican-American, Chicano

Central American

South American

Hispanic: Other

Education Information

Enrollment Status *

High School Education Level

High School Completion Date

Highest Education Level

Last High School Attended

Other California H.S. Name

Graduated from CA High School

Yes

No

Attended HS in CA for 3 Years

Yes

No

Number of Colleges Attended

None

1

2

3

4

Expelled from College?

Yes

College 1

College Name

Other College Name

Start Date

End Date

Expelled?

Yes

Degree Obtained

Date Conferred

College 2

College Name

Other College Name

Start Date

End Date

Expelled?

Yes

Degree Obtained

Date Conferred

College 3

College Name

Other College Name

Start Date

End Date

Expelled?

Degree Obtained

Date Conferred

College 4

College Name

Other College Name

Start Date

End Date

Expelled?

Degree Obtained

Date Conferred

Citizenship/Visa Information

Citizenship Status *

Visa/Permit Information

Alien Registration Number

Expiration Date

Issue Date

No Documents

Yes

No Expiration Date

Military/Veteran

Military Status

Military/Veteran Information

Discharge Date

Discharge Type

Military Legal Residence

Military Home State

Military Home Country

Stationed in CA?

Yes

No

Stationed in CA for Education?

Yes

No

Branch of Service

Residency Information

California Resident for at least 2 Years?

Yes

No

Date Current Stay Begin

Not Yet Arrived in CA

Yes

CA College Employee?

Yes

No

CA School Employee

Yes

No

Seasonal Ag Worker

Yes

No

Foster Youth?

Yes

No

Foster Youth Status

Outside State Taxes

Yes

No

Year

Voted Outside CA?

Yes

No

Year

Outside College?

Yes

No

Year

Outside Lawsuit

Yes

No

Year

Comfortable with English?

Yes

No

Athletic Interest?

Yes

No

Financial Assistance?

Yes

No

TANF/SSI?

Yes

No

CACCRAO

The California Association of Community College Registrars and Admissions Officers (CACCRAO) is the professional association for admissions and records staff from the 113 public community colleges in California. CACCRAO is instrumental in supporting training and providing professional development opportunities to new and seasoned registrars, admissions and records managers and their staff.

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