Application For Admission

I plan to attend:

Moorpark College

Oxnard College

Ventura College

I am applying for the year:

Email:

SSN (if applicable)

- -

First Name:		Middle Initial:
Last Name:

Birth Date:	- -    (MM-DD-YYYY)
Country of birth:
Country of citizenship:

Sex:

Male

Female

Address:
Street:
City:
State:
Zip Code:

Telephone Number:   - -

Last high school attended:

Name:

Country:

High school graduation or date last attended:   -    (MM-YYYY)

Proposed Major:

Last college attended:

Please list Name, City, State, Country

California Drivers License Number:

Indicate Your Ethnicity: (Confidential & Voluntary)
Asian	Central American
Chinese	South American
Asian Indian	Other Hispanic
Japanese	American Indian/Alaskan Native
Korean	Laotian
Other non-White	Cambodian
Pacific Islander	Vietnamese
Guamanian	Other Asian
Hawaiian	Black, Non-Hispanic
Samoan	Filipino
White	Hispanic
Unknown	Chicano, Mexican, Mex-American, Chicano
Decline to State

Primary Language:	English	Not English
Immigration status:	Student Visa (F-1, M-1, J-1)		Other Visa

Student Academic Level: (Please indicate your education status at the beginning of the semester for which you are applying. Mark the highest level of education attained.)

Not a High School Graduate:

Not a graduate of, and no longer enrolled in high school

Special admit student currently enrolled in high school

Currently enrolled in Adult School

High School graduate:

Foreign High School Diploma / Certificate of Graduation

U.S High School Diploma

GED or High School Certificate of Equivalency / Completion

Certificate of California High School Proficiency Exam

College Degree Received:

Associate Degree

Bachelor Degree or higher

Student Enrollment Status:

First-time student. A student enrolled in any college for the first time.

First-time transfer student. A student enrolled at this college for the first      time and who has transferred from another college after earning credit.

Returning transfer student. A student who has previously attended this      college, transferred to another college, and has now returned to this college.

Returning student. A student enrolled at this college after an absence of      one or more regular sessions without interim attendance at another college.

Special admissions student. A student who is currently enrolled in K-10 or      a senior high school student currently enrolled in 11-12.

Student Educational Goal: (Select your highest priority)

Obtain a bachelor degree after completing an associate's degree

Obtain a bachelor degree without completing an associate's degree

Obtain a two year associate degree without transfer

Obtain a two year vocational degree without transfer

Earn a vocational certificate without transfer

Discover / formulate career interests, plans, goals

Prepare for new career (acquire job skills)

Advance in current job / career (update job skills)

Maintain certificate or license (e.g. Nursing, Real Estate)

Educational development (intellectual, cultural)

Improve basic skills in English, reading or math

Complete credits for high school diploma or GED

Undecided on Goal