Jesus mtz

Páginas: 6 (1258 palabras) Publicado: 29 de octubre de 2010
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APPLICATION CONFIRMATION |
Your application for admission has been submitted to State Center Community College District. Thank you. * Please print a copy of this page for your records. * You may also print a copy of your SUBMITTED INFORMATION for your records. * Remember to complete any additional admission requirements as specified in the introduction of this application. *CHECK YOUR EMAIL (including your spam folder) for important information from State Center Community College District regarding your admission and registration. Required information should be sent to the appropriate college below: |
Fresno City College
1101 E. University Ave.
Fresno, CA 93741

Telephone:  (559) 442-4600
Website:  www.fresnocitycollege.edu | Reedley College
995 N. Reed Ave.Reedley, CA 93654

Telephone:  (559) 638-3641
Website:  www.reedleycollege.edu | Willow/International Center
10309 N. Willow Avenue
Fresno, CA 93730

Telephone:  (559) 325-5200
Fax number:  (559) 325-5299
Website:  www.willowinternationalcenter.com  |
Madera Center
30277 Avenue 12
Madera, CA 93638

Telephone:  (559) 675-4800
Fax number:  (559) 675-4820Website:  www.maderacenter.com  | Oakhurst Center
40241 Hwy. 41 Building G
Oakhurst, CA 93644

Telephone:  (559) 683-3940
Fax number:  (559) 683-4193
Website:  www.oakhurstcenter.com  | Clovis Community College Center
390 West Fir
Clovis, CA 93611

Telephone:  (559) 323-4595
Fax number:  (559) 324-6490
Website:  www.cloviscenter.com  |
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Applicant name: | Roberto Carlos Vizcaino |
College: | State CenterCommunity College District |
Application term: | 2010 Summer/Fall |
Email address: | roberto.vizcaino84@hotmail.com |
Date submitted: | 6/1/2010 1:51:00 PM |
Confirmation number: | 3547-2010SU-5-06012010-19978198-17417289
(This is not a student identification number) |
You may return to this Confirmation Page at any time
via the Submitted Applications section of My Applications. |
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State Center Community College District Student Print
This is for your records ONLY. Do NOT send to the college!

Confirmation number: 3547-2010SU-5-06012010-19978198-17417289
Date submitted: June 1, 2010 at 1:51:00 PM
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SCREEN 1: ENROLLMENT INFORMATION |
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TERM & MAJOR |
Term applying for: | 2010 Summer/Fall |
Intended major or program of study: | R5000T |
Educationalgoal: | Undecided on goal |
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SCREEN 2: PERSONAL INFORMATION |
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STUDENT NAME |
Last/Family name: | Vizcaino |
Suffix: |   |
First/Given name: | Roberto |
Check if no first name: |   |
Middle name: | Carlos |
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Other last name: |   |
Other first name: |   |
Check if no first name: |   |
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SOCIAL SECURITY NUMBER |
Social Security number: | ***-**-****|
Check this box if you have no Social Security number or decline to state: |   |
Please confirm your Social Security number: | ***-**-**** |
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DATE OF BIRTH |
Date of birth: | 4/2/1984 |
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MARITAL STATUS |
Marital Status: | Unmarried |
If you will be under 19 years of age on 6/1/2010, please select the statement that will apply to you: |   |
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GENDER |
Gender: | Male ||
RACE/ETHNICITY |
Are you Hispanic or Latino? | Yes |
What is your race/ethnicity? | Mexican, Mexican-American, Chicano |
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SCREEN 3: CONTACT INFORMATION |
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CURRENT MAILING ADDRESS |
Street Address or PO Box: | 7765 Ave 430 |
Street Address or PO Box 2: |   |
City: | Dinuba |
U.S. State: | California |
Non-U.S. State/Province: |   |
U.S. Zip Code: |93618 |
Non-U.S. Postal Code: |   |
Country: | United States |
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PERMANENT ADDRESS |
Check here if this address is the same as your current mailing address: | X |
Street Address: | 7765 Ave 430 |
Street Address 2: |   |
City: | Dinuba |
U.S. State: | California |
Non-U.S. State/Province: |   |
U.S. Zip Code: | 93618 |
Non-U.S. Postal Code: |   |
Country: | United...
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