Puente

Note: Unless noted, all fields required.

Student Information

First name:

Last name:

Email:

Re-enter email:

Phone:

Permenant Address:

City: State: Zip:

Please provide a local address, if different than above:

Student ID/CWID:

Education

High School:
Did you graduate?   Yes   No   If yes, year:

Other college:   Units completed:
Other college:   Units completed:

Major or other academic interests:

Do you plan to transfer to a four-year university?   Yes No Don't know

Additional Information

Working while attending school?   Yes No Don't know
If yes, how many hours a week?

Eligible for Financial Aid?   Yes No Don't know

Taken any placement tests?   Yes No
If YES, check all that apply:   English   Math

Please Describe Your Academic/Career Goals:

How did you hear about Puente?

If from a Puente student or Counselor, please provide their name:

Human verification time!