Social Security Number (state law determines that this is not required, but we highly recommend providing it for tax and other purposes):
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Primary phone number: *
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Street1 (Street Number and Street Name): *
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Street2 (optional):
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City: *
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State: *
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Zip: *
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Gender identity (optional):
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Sexual orientation (optional):
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Have you ever taken any coursework at SOU previously? *
If you have taken coursework at SOU previously, and you know your SOU ID # (940 number), please provide it:
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If you have taken coursework at SOU previously, and you had a different name at the time, please indicate what your name was:
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Do you consider yourself a resident of Oregon? *
Do you have a high school diploma or GED? *
If you have a high school diploma or GED, please indicate where from (high school name, city, and state/country, or just indicate "GED" if you have a GED):
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Do you have a bachelor's degree? *
If you have a bachelor's degree, please indicate where from (college or university name, city, and state/country):
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