Interest form

College Access Latinx Initiative (CALI)

Our mission is to support Latino/a/x students by connecting them with resources and programs available to help support their education here at PCC.

Are you interested in being a potential applicant? Fill out the form below so we can follow up with you, answer any questions and reach out to you when CALI’s next year application is available.

Some questions require an answer to continue.

"*" indicates required fields

What is your name? / Cómo te llamas?*

First name / Primer nombre Last name / Apellido

Do you identify as Latino/a/x and/or Indigenous? / Te identificas como latino/a/x y/o indígena?*

(Mexico, Central, South America, and the Caribbean / México, Centro, Sudamérica y el Caribe)

Yes / Si

No / No

Not sure / No estoy seguro

Other

Are you a current PCC Student? / Es un estudiante de PCC actualmente?*

Yes / Si

No / No

Not sure / No estoy seguro

Other

PCC ID number / PCC número de estudiante

(if applicable / si es aplicable)

What is the highest grade or level of school that you have completed?/ Cuál es el grado o nivel escolar más alto que ha completado?*

Middle School (Grades 6-8)/ Escuela Intermedia (Grados 6-8)

Freshman (Grade 9/Grado 9)

Sophomore (Grade 10/Grado 10)

Junior (Grade 11/Grado 11)

Senior (Grade 12/Grado 12)

High School Graduate/ Graduado de preparatoria

Some College/Alguna educación superior

GED

Other

What is your goal or plan to study at PCC? / Cuál es tu meta o plan para estudiar en PCC?

How would you like to be contacted? / Cómo le gustaría ser contactado?*

By email / Por correo electrónico

By phone / Por teléfono

Please leave any additional information or questions in the space provided below. / Por favor deje cualquier información adicional o preguntas en el espacio proporcionado a continuación.

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