Active EOPS students do not need to reapply. General Information: Term of Application Is this your first time applying for MC EOPS? Yes No, I am reapplying for MC EOPS I am part of an EOPS program at another college and would like to transfer to MC EOPS First Name Last Name Preferred Name Student ID? Best Phone Number to Contact You Birth Date Email Address Intended Major Ethnic Background Ethnic Background - Select -African-American/BlackAsian/Pacific IslanderLatinx/Chicanx/HispanicNative AmericanWhite/CaucasianDecline to stateOther… Enter other… Additional Information? ACCESS Participant (Please provide a verification letter from ACCESS after you are accepted) CalWORKs Recipient (TANF) English is not my primary language First Generation College Student (parents did not complete a four-year college degree) Foster Youth (current or emancipated. Confidential: you may be eligible for additional services) I am an AB540/Dreamer Student Single Parent/Guardian (if yes, ask about CARE) High School GPA was below 2.5 I have not completed more than 50 units I am a homeless youth None of these options apply to me Have you lived in California for at least a year and a day? Yes No Pre-College Information: Unoffical transcripts must be submitted with your application High School Attended Year Completed High School Information Graduated High School Did Not Graduate High School GED College Information: List all colleges/universities attended, including current school. (For colleges outside of VCCCD, you will be asked to provide unoffical transcripts in a follow-up email to complete your application). Name of College(s) Currently Attending Name of College(s) Previously Attended Prior College Degrees Conferred Are you interested in participating in our peer mentor program (you would be paired with a fellow EOPS student who will support your Educational journey)? Yes No Maybe, I'd like more information Agreement: I agree to provide any documentation needed to detemine eligibility, and I give permission to review high school and/or college records. I understand that any false statement made on this application may result in penalties, including but not limited to being denied EOPS/CARE services or having to make repayment for servies already rendered. By typing my name below, I acknowledge that all the information contained in this application for Extended Opportunities Program & Services is correct to the best of my knowledge. Signature CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.