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EAST LOS ANGELES COLLEGE
ADMISSIONS APPLICATION
1. (a.) Social security system take (*): 2. Semester: 3. (a.) Legal name:
Last First Middle Initial (b.) List bran-new(prenominal) names you have utilise. If none, check box:
Suffix: jr./Sr.

4. Birth Date:

Students are required by fairness to provide their Social Security Number, which go forth be use for reporting to the federal government under the Taxpayer Relief stage of 1997 and for financial aid verification. If you do non have a Social Security Number, or if you do not inclination to use it, please leave blank.

Winter Spring pass Fall
Year:

/

/

Month/Day/Year Age: 5. sex activity: ? Female
?

Last

First

Middle Initial

Suffix: Jr./Sr.

Male

(b.) Student Identification Number (SIN):

6. Legal speak to/Residence (Do NOT Use P.O. stroke or Business Address):
I have lived at this compensate since: Month Day Year
(If you have lived at this address few than two years please answer question #7.)

9. tint Information: Male
Primary Phone:

8 8
The Social Security Number will no longer be used as primary student identifier for students per Civil Code 1798.85. The College will generate an identification number for each student who is new to the LACCD. Leave blank if you have not been assigned a SIN by the college and/or district.





(
Email: Number highway/Apt # City adduce Zip Code

)

7. If you have lived at your preface address fewer than two years, list preceding address:

8. Mailing Address (if different from Legal Address/Residence given above):
Number/Street/Apt. # City/State Zip Code

Number/Street/Apt. #

City/State

Zip Code

From: Mo./Yr. To: Mo./Yr.

10. specify of Birth:

11. (a.) I am a citizen of (Country): (b.) If you are not a United States Citizen, please check one:
2. ? persistent Resident 3. ? Temporary Resident 4. ? Refugee, Asylum 5. ? Student visa (F1 or M1 Visa) 6. ? Other (Specify) 7. ? Visitor Visa (B1 or B2)

12. My present stay in California began:
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