Question Title

* 1. STUDENT ID:

Question Title

* 2. FIRST NAME:

Question Title

* 3. LAST NAME:

Question Title

* 4. PHONE:

Question Title

* 5. EMAIL:

Question Title

* 6. ADDRESS:

Question Title

* 7. CITY:

Question Title

* 8. STATE:

Question Title

* 9. ZIP:

Question Title

* 10. I intend to establish California residency while at College of the Siskiyous.

Question Title

* 11. I will complete EDUC 0670 Critical Skills Lab, a 0 Unit Non-Credit course. There is no enrollment fee for the course. 

T