Fillable CHABOT Chabot College Puente Project A Learning Community (Chabot College)

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CHABOT Chabot College Puente Project A Learning Community (Chabot College)

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Chabot College Puente Project
A Learning Community Since 1981
CHABOT
COLL[ f
Thank you for your interest in the Puente Project. Please review the process and participation
criteria before you complete.
Criteria:
Interest in transferring to and graduating from a 4 year university or college
G.P.A. of 2.0 or higher. (Students who do not meet this criterion should submit a letter of
recommendation from an instructor or counselor with the application)
Willingness to learn about the Mexican American/Latino experience
Willingness to participate in career and college field trips, service learning, and mentoring events
that take place outside of regular class time
Eligibility to enroll in the assigned Puente PSCN classes, English 1 (fall semester) or English 7
(spring semester)
Puente Project 2 - Semester Agreement & Commitment
Puente English courses each semester develop critical reading and writing skills necessary to
succeed in college or university.
Puente Counseling and Counseling-Psychology courses each semester to develop self-
confidence, self-understanding and student success skills necessary to make it in college or
university, a knowledge of resources, requirements and an Educational Plan necessary for
transfer.
Puente Mentoring each semester by volunteers in professional careers to help develop skills
necessary for the professional world.
Puente educational, career and cultural activities each semester that further support students in
developing career and life goals.
Personal Information
Date:
Interested to start:Fall
Spring
Year:
Legal Name:
Preferred Name:
Address:
Chabot Id. #:
City:
Date of Birth:
Zip Code:
Home Phone:
T-shirt Size:
Cell Phone:
Dietary Restrictions: Ex. Vegan, Vegetarian, Gluten Free?
Gender:
Pronouns: He, Him, His/ She, Her,
Hers/ Other:
E-mail address required:
Academic Information
High school graduate? Yes No Year graduated/will graduate: ____
Name
of high
school:
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Were you in a Puente program in middle school or high school? Yes No
If you are currently a high school senior, what is your overall GPA:

Name of
other colleges attended:
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College units completed: _
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Do you plan to transfer to a four-year university? Yes
No Don't Know
Major Interest:
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Career Interests:
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Preferred Transfer College(s):
2
Student Work Information
If you have a job, how many
hours do you work?
30-40 per week
20-29 per week
10-19 per week
5-9 per week
I do not have a job
I help out my family
(babysitting, picki ng up siblin gs,
etc.). I spend about ___ hours
per week supporting my family.
Typically, how many hours of
community service do you do?
15-20 per week
10-14 per week
5-9 per week
1-4 per week
I have not been involved in
community service activities
Essay Answers (3 questions)
Respond to the following questions. Write in paragraph form for each response and use
the back of the page if you need additional space.
1. Why do you want to be in the Puente program at Chabot College?
3
2. What challenges have you faced in your academic experience? (This may include
challenges you are facing now or think you might face as you transition to college).
3. De scribe your academic and career interests.
NOTE: By signing this Information sheet, you are allowing the Chabot College Puente Project
to use your photo and information to share with the Chabot Puente Project, approve d mentors
and the Puente State Office
for data collection and tracking purposes.
Signature:
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Date:

Thank you for completing the information sheet. Please submit completed Intake
form as an attachment by email to:
Kenya
Orochena
Chabot College Puente Office Manager
korochena@chabotcollege.edu
Office Use Only
Application received on:
Attended informational session or counseling appointment:
I
Writing:
Current college GPA:
Assessment Scores:
Reading:
Math:
Intent to Regis ter Form sent on:
Course Recommendation:
Course Recommendation:
Intent to Register form received on:
4
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CHABOT Chabot College Puente Project A Learning Community (Chabot College)

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Completed 3 September 2020

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