CHILD, YOUTH, AND FAMILY STUDIES
BACHELOR OF APPLIED SCIENCE APPLICATION FALL 2020
CYFS-BAS APPLICATION FORM
(Type using PDF fillable form)
DEMOGRAPHICS
Edmonds CC Student ID Number: Birthdate:
Last Name:
Previous Last Name(s):
Legal First Name:
Middle Name:
Preferred First Name:
Preferred Pronouns (e.g., she/her):
Student EdMail:
Alternate Email:
Day Telephone Number:
Evening Telephone Number:
Address Number and Street, Apt. #:
City, State, Zip Code:
ACADEMIC HISTORY (If additional room is needed, attach another page)
Educational Institution (no abbreviations), Location
Start/End Years
Graduated?
Degree Earned
Last College:
Other College:
PRACTICUM, INTERNSHIP, AND VOLUNTEER (If additional room is needed, attach another page)
Most Recent Placement:
Name and Location
Start/End Date
Position/Title
Summary of tasks and duties:
Previous Placement:
Name and
Location Start/End Date
Position/Title
Summary of tasks and duties:
Rev. 01/2020_TL
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CHILD, YOUTH, AND FAMILY STUDIES
BACHELOR OF APPLIED SCIENCE APPLICATION FALL 2020
RELEVANT EMPLOYMENT (If additional room is needed, attach another page)
Most Recent Employer:
Name and Location
Start/End Date
Position/Title
Summary of job duties:
Previous Employer:
Name and Location
Start/End Date
Position/Title
Summary of job duties:
STATEMENT OF PURPOSE
(Type and attach separately)
The CYFS-BAS is an interdisciplinary program, integrating Early Childhood Education and Social and Human
Services, with a foundation in social justice, equity, and inclusion. This writing sample provides an opportunity
for the Admissions Committee to learn more about your future goals, and is an important part of the CYFS-BAS
application. In an essay of no more than three double-spaced pages, please write a statement of purpose clearly
addressing the following two prompts:
1. Understanding that the CYFS-BAS is an interdisciplinary program grounded in social justice, equity, and
inclusion, describe how you plan to use this degree to reach your future goals.
2. Explain what you learned from practicum, internship, volunteer, and/or work experiences and how this
applies to your professional career.
SIGNATURE
Please review your application for accuracy. If you agree the information on this form and in the attached essay
is complete and correct as states, please sign below. Electronic signature represents valid signature.
Applicant Signature: Date:
Rev. 01/2020_TL
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