JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Dual Enrollment Counseling Appointment Request
Fill out this form if you need to speak to a counselor.
We will connect with you as soon as possible.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
GCC ID Number
*
Your answer
Date of Birth
*
Your answer
Personal Email (Not your high school email)
*
Your answer
Phone Number
*
Your answer
High School you are currently attending
*
Your answer
What grade are you currently in?
*
9th
10th
11th
12th
What is your major or career interest?
Arts, Media and Entertainment
Engineering and Design / Manufacturing & Product Development
Health Science, Medical Information Technology & Biotechnology
Hospitality Tourism and Recreation
Information (IT) and Office Technology
Public Service
Transportation
Education, Child Development, and Family Services
Other:
Clear selection
Reasons for meeting with a counselor
*
Need help identifying classes for Summer 2024
Need help identifying classes for Fall 2024 semester
Current ECA student at Hoover HS
Current CCCS student at Glendale HS
Current OCCA student at Verdugo Academy
CalWORKs
Discussing challenges impacting academic grades
Other:
If you are a
graduating high school senior
, you no longer need to speak to our Dual Enrollment counselor.
As a first time college student, you may qualify for our
Promise+ Plus program
. Visit our website for next steps.
Sounds good!
Other:
Clear selection
Have you submitted your
Annual Digital Form
and had it signed by your parent and HS counselor or principal?
*
Yes
No
I don't know what that is
Other:
If you need prerequisite clearance, click
here
.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Glendale Community College.
Report Abuse
Forms