S.T.E.M. STUDENT INTEREST FORM
Science, Technology, Engineering and Mathematics
www.oxnardcollege.edu/STEM
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First Name *
Last Name *
Address *
City *
Zip Code *
Phone Number *
Email *
Oxnard College Student ID# *
900#
Gender
Clear selection
Ethic Identification:
(for statistical purpose only)
Clear selection
Race
(for statistical purpose only)
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Please indicate your Mother's level of education:
Please check all boxes that apply
Please indicate your Father's level of education:
Please check all boxes that apply
How did you hear about STEM at Oxnard College?
Please check all boxes that apply
Major and University Transfer Information:
What major are you currently pursuing at Oxnard College?
Please indicate if you are undecided or undeclared.
If not a STEM major, please indicate STEM class enrolled in:
What semester and year are you currently completing?
Clear selection
What are your educational plans while at Oxnard College?
Clear selection
Have you been admitted to a four-year university for next term?
Clear selection
If Yes, indicate the university;     If NO, when do you think you will transfer to a university?(Term/Year)
Which universities are you interested in attending?
Please indicate 1st, 2nd, and 3rd choice.
Thank you for your interest in STEM at Oxnard College!
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