.XL First-Year Experience Programs Application

If you are interested in participating in one of the .XL First-Year Experience Programs at Pasadena City College, please carefully complete this application.

* All fields with an asterisk must be completed

Student Data

First Name:	*	Last Name:	*
Phone #:	*
E-mail Address:	*
Street Address:	*

City:

State:

Zip:

High School Information

High School:	*
High School GPA:	*

Goals Why do you want to attend college? *

to transfer to a four-year college or university

to complete an AA/AS degree and NOT transfer

to complete a vocational certificate

Undecided

I am interested in a major/career in: *

Additional Information

What is the highest academic degree achieved by your
- Father:
- Mother:
- If you have brothers and/or sisters, have any of them
  - attended a community college Yes No
  - attended a university Yes No
  - graduated from a university Yes No

What language(s) do you speak at home?
Are you planning to work while you attend college? Yes No
If you have one or more disabilities or have completed an IEP for which you require academic accommodations, please specify.
What is you ethnic background?