Statway Interest - Martinez

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Please complete the form below to begin the registration process for the Pierce College Statway program.

You will be signing up for the following cohort:

<table>
<tr>
<td>9:35 - 10:45 am</td>
<td>MTWTh</td>
<td>Math 228A Statway I</td>
<td>Math 1400</td>
<td>Martinez, RM</td>
</tr>
<tr>
<td>10:45 -11:00 am </td>
<td>MTWTh</td>
<td>Study Skills</td>
<td>Martinez, RM</td>
<td>Math 1400</td>
</tr>
</table>

<strong>Submitting the form does not guarantee you a space in the program. You must attend the orientation on <span style="color: #c00000;">August 24, 2012 from 10:00am – 11:30am, </span>where you will receive your add cards. </strong>

BACK TO STATWAY WEBSITE: http://www.piercecollege.edu/departments/mathematics/statway.asp

First Name *

Last Name *

Student ID Number *

This is your 88 Number

E-mail address *

Please make sure your e-mail address is accurate. This is how you will receive your confirmation.

Telephone Number *

Please choose the option that applies to you: *

I took the assessment test and tested into math 115.

I took the assessment test and tested into math 120/125.

I have taken math 110 or 112 and passed with a C or better.

Other:

Have you taken an English assessment test at Pierce College? *

Yes

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