Oregon Extension Student Application
Thank you for your interest in the Oregon Extension. Please fill out the entire application. Questions about the application process can be emailed to admissions@oregonextension.org
Sign in to Google to save your progress. Learn more
First Name
Last Name
College from which you are applying (e.g University of Honolulu)
Date of Birth
Clear selection
Academic Major
Proposed Year of Graduation from college
Clear selection
Year in college during the Fall you are at the OE
Clear selection
College Mailing Address
Email Address
Cell Phone Number
Home/Summer Mailing Address
Which Fall semester are you applying for?
Clear selection
Name of Parent or Guardian
Mailing Address of Parent or Guardian
Phone number of Parent or Guardian
Name of the college professor who is writing your recommendation
Email of the college professor who is writing your recommendation
Do you have allergies, disabilities or conditions requiring medical attention that you think we should know about? If so explain here.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Oregon Extension. Report Abuse