Name:
Delta Id Number:
Date of Birth:
1. What is your current high school status?
Basic Arithmetic
Pre-algebra
Elementary Algebra (Algebra 1), Geometry, or Integrated Math 1 or 2
Intermediate Algebra (Algebra 2) or Integrated Math 3 or 4
AP Algebra, College Algebra, or Statistics
Precalculus or Trigonometry
Calculus
3. Please indicate your HS GPA:
I hereby certify that the above information is true and correct to the best of my knowledge.
Office
Placement: Read:
Comp: Math:
Use
Only Prepared by: ___________________________ Date: _____________________
4. Signature: _________________________________________
5. Return to the Assessment Center - mail: 5151 Pacific Ave, Stockton CA 95207 / FAX:
209-954-3833 / email: assessmentcenter@deltacollege.edu
2. Please select from the list below the highest Math course you have completed with a grade of
"C" or higher.
Please check ONE (1) box for each question below:
Currently enrolled in the 12th grade in a U.S. high school
Graduated from a U.S. high school within last 10 years
Neither of these applies to me
Local Background Questions:
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