ADMISSIONS APPLICATION
1. (a.) Social trade protection Number (*):
2. Semester:
Students argon mandatory by law to provide their Social Security
Number, which will be usaged for reporting to the federal
government under the Taxpayer Relief knead of 1997 and for
financial aid verification. If you do not have a Social Security
Number, or if you do not wish to use it, please leave blank.
3. (a.) Legal Name:
Winter
Spring
Summer
Fall
/
Last
First
Middle Initial
(b.) inclination other names you have utilize. If n cardinal, check box:
suffix: Jr./Sr.
Last
Year:
(b.) Student Identification Number ( netherworld):
4. put up Date:
Suffix: Jr./Sr.
First
Middle Initial
6. Legal administer/Residence (Do NOT Use P.O. Box or line of merchandise Address):
88
I have lived at this address since: Month
solar day
/
Month/Day/Year
Age:
5. Gender:
? Female
?
Male
9. Contact Information:
Male
Primary visit:
Year
(If you have lived at this address fewer than twain days please answer question #7 .)
(
The Social Security Number will no longer be used as primary
student identifier for students per Civil Code 1798.85. The College
will pay back an identification number for each student who is new to
the LACCD. relinquish blank if you have not been assigned a SIN by the
college and/or district.
)
Email:
Number
pathway /Apt #
City
State
vitality Code
7. If you have lived at your present address fewer than two years, list previous address:
8. Mailing Address (if dissimilar from Legal Address/Residence given above):
Number/Street/Apt. #
Number/Street/Apt. #
10. Place of Birth:
City/State
speed Code
From: Mo./Yr. To: Mo./Yr.
11. (a.) I am a citizen of (Country):
12. My present stay in California began:
(If you were born in CA and have neer lived in another state
please enter your birth date.)
(b.) If you are not a United States Citizen, please check one:
City
State/Country
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