APPLICATION FOR COLLEGE ACHIEVEMENT PROGRAM
APPLICATION DEADLINE: Applications will be accepted through first week of classes - IDC 326B
Please type or print clearly: TURN IN TO: IDC 326B or email to millward@sbcc.edu
Name ______________ K # ________ _
Address
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Street address City State Zip Code
Phone number (where we are most like to reach you) ____________ _
1. Please provide information on your academic background ( check all that apply):
___ High School graduate
___ G.E.D; Year received
___ First year SBCC student
___ Year of high school graduation
___ Second year SBCC student
___ Other
2. What are your educational goals? (Please check all that apply .)
___ Certificate
____ Associates Degree
___ Transfer to a four-year college or university
3. Have you declared your major? __ Yes
___ No
If yes, what is your major? ___________________ _
If you have not declared your major, what classes or areas of study most interest you?
4. Are you planning to work while you attend SBCC? ___ Yes
___ No
If yes, approximately how many hours a week are you planning to work? ____ _
5. Are you a member of EOPS:
___ Yes
___ No
6. Name of reference:
------------------
(Put current teacher's name above if you have no other reference)
7. Achieving success in college often means balancing different types of responsibilities-including
school, family (responsibility for children, siblings, parents or others), work, and personal
finances-or meeting academic challenges (including re-entry, underperformance, etc.). CAP is
designed to help you achieve this balance. On a separate sheet of paper, please briefly describe your
personal goals, strengths, and your academic or personal challenges. Please make sure to include
your name and to attach your response to this application .
