Eastfield College -- New Students Orientation Registration

Spring 2012

Student Name*:
7 digit Student ID:
Family Member Name*: (if attending with a family member)
Email Address:
Mailing Address*:
City*:
State*:
Zip Code*:
Telephone:
Cell Phone:	Cell Phone Carrier:
What do you expect to learn at New Student Orientation?
Will your parents or family member attend the Bilingual session (English/Spanish) hosted during the New Student Orientation session?		Yes No
Are you interested in an English/Spanish session?		Yes No
Are you a first generation college student (neither parent nor sibling has attended)?		Yes No
Are you a Veteran?		Yes No
Do you need sign language interpreters or other accommodations due to a disability? Please contact the Disability Services Office at efcdso@dcccd.edu or 972-860-8348.		Yes No
How do you prefer to receive information? Email Text messaging
Which session will you attend? Saturday, January 7, 2012 at 8:30 a.m.