Hartnell College APPLICATION FOR ADMISSION Admissions Office FALL 411 Central Avenue, Salinas, CA 93901 SPRING Year 20 Phone: (831) 755-6711 SUMMER www.hartnell.edu 1. LEGAL NAME, CURREN T & PERMANENT ADDRESS Provide your legal name as it appears on your Social Security card. Legal name will appear on all official records, including transcripts.
Last Name: First Name: ______
Prev ious name(s):
Current Mailing/Local Address:
City: State: Zip/Postal Code:
Local Phone: (_ ) - Cell Work Alternate Phone: ( ) - Cell Work
Personal E-mail Address: @
2. SOCIAL SECURITY or HARTNELL STUDENT ID# 3. GENDER 4. DATE OR BIRTH
Female Male Decline to State / / MONTH DAY YEAR
5. ETHNICITY / RACE Per U.S. Department of Education guidelines, colleges are required to collect the following racial and ethnic data. (Check all that apply)
Are you of Hispanic or Latino ethnicity? Yes No
(HM) Mexican, Mexican-American, Chicano (AC) Asian: Chinese (AV) Asian: Vietnamese (PG) Pacific Islander: Guamanian (HR) Central American (AJ) Asian: Japanese (F.) Filipino (PH) Pacific Islander: Hawaiian (HS) South American (AK) Asian: Korean (AX) Asian: Other (PS) Pacific Islander: Samoan (HX) Hispanic: Other (AL) Asian: Laotian (B.) Black or African American (PX) Pacific Islander: Other (AI) Asian: Indian (AM) Asian: Cambodian (N.) American Indian/Alaskan Native (W.) White
6. SEXUAL ORIENTATION/TRANSGENDER By California Law, the California Community College voluntary demographic information regarding the sexual orientation, gender identity, and gender expression of students. This information is only used for summary demographic reporting, your responses are kept private and secure, providing this information is optional, it is not available to admissions personnel and will not be used for discriminatory purposes.
Straight/Heterosexual Gay or Lesbian/Homosexual Bisexual Other Decline to state
7. MAJOR/ACADEMIC PROGRAM 8. ADMIT STATUS (Check one)
(required) (HS) High School (FT) First-time Student in college (after leaving high school) (See last page for list of codes.) (grades 9-12) (TRAN) Have attended another college, First time at Hartnell
(RFS) Returning Student to Hartnell after absent for a main term (K8) Grade School (RTS) Returning Student to Hartnell after attending another college (K-8)
9. EDUCATIONAL GOAL (Check one) (UPJOB) Advance in current job/career (update job skills). (BWAA) Obtain an associate degree and transfer to a 4-year institution. (LIC) Maintain certificate or license (e.g. Nursing, Welding). (BWOAA) Transfer to a 4-year institution without an associate degree. (EDDEV) Educational development (intellectual, cultural, physical). (VAWOT) Obtain a 2-year vocational degree without transfer. (BSSK) Improve basic skills in English, reading or math. (VOCCT) Earn a vocational certificate without transfer. (HSDIP) Complete credits for high school diploma or GED. (NCCW) NonCredit Coursework to Credit. (UND) Undecided on goal. (4 Year) 4-year Course Requirement
IS ENGLISH YOUR PRIMARY SPOKEN LANGUAGE YES NO OTHER
OFFICE USE ONLY:
Student ID Number: Residency Status: Entered by: Date:
11/6/2020 1
10. CITIZENSHIP (required) 11. HAVE YOU LIVED IN CALIFORNIA CONTINUOUSLY FOR THE PRIOR ARE YOU A UNITED STATES CITIZEN? TWO (2) YEARS? (required) YES NO YES NO If you are not a U.S. Citizen, check one of the following below. If NO, when did your CURRENT stay in California begin? Alien ID number and issue/expiration date required. (2) Non-US Citizen Permanent Resident * / / (3) Non-US Citizen Temporary Resident * MONTH DAY YEAR (4) Non-US Citizen Refugee / Asylee * List the address(es) where you have lived for the past two years, beginning with your (5) Non-US Citizen Student Visa F1 or M1 current address. (6) Other Status– Visa Type: FROM TO (7) No Documents CITY STATE (Month//Year) (Month/Year) (8) Amnesty *Permanent/Temporary Card number:
Issue Date: MM DD YYYY
12. LAST HIGH SCHOOL ATTENDED (required) Select one: High School: Not a high school graduate and not attending high school (0) Dates Attended From: To: Currently enrolled in K-12 (1) Enrolled in Adult School (2) City: State: Received high school diploma (3) Passed GED/Certificate of Proficiency (5) High School Code: (See last page for list of codes.) Foreign Secondary School Diploma (6)
Completion Date: (graduation/GED received)
13. LAST COLLEGE/UNIVERSITY ATTENDED (if applicable) 14. INTENDED LOAD
College/University: Select one: (L) Less than Half Time Attended From: To: Received an Associate’s Degree (7) (H) Half Time Received a Bachelor’s Degree (8) (T) Three-Quarter Time City: State: Received a Graduate’s Degree or higher (10) (F) Full Time (O) Overload College Code: (See last page for list of codes.) Completion Date: (graduation) (NA) Not Applicable
15. NEEDS AND INTERESTS — optional (Check all that apply) (ABT) Ability to Benefit (CW) CalWorks (BB) Baseball (BS) Basic Skills (reading writing, math) (DSPS) Disabled Students (BK) Basketball (CA) CARE (EA) Employment Assistance (CC) Cross Country (CC) Child Care (EOPS) Extended Opportunity programs and Services (FB) Football (CO) Academic Counseling, Advising (ESL) English as a Second Language (SC) Soccer (CP) Counseling - Personal (FA) Financial Aid (SB) Softball (CT) Tutoring Information (TS) Transfer Information (VB) Volley ball (VT) Veterans Services (TR) Track
16. PARENT/GUARDIAN EDUCATION LEVEL (required) Regardless of your age, please indicate the highest education level of any parent or guardian who played the largest role in your upbringing: 1 = Grade 9 or Less 2 = Grade 10, 11, or 12 but did not graduate 3 = High school graduate First Parent (Guardian) Educational Level: 4 = Some college but no degree 5 = AA/AS Degree Second Parent (Guardian) Education Level: 6 = BA/BS Degree 7 = Graduate or professional degree beyond BA/BS Y = Not applicable, no second parent/guardian X = Unknown
17. FOSTER YOUTH (if applicable) Answer the following if you are under 24 years of age: Have you ever been in court ordered Foster Care? Yes No If yes, select one of the following: I am currently in Foster Care in California. I am currently in Foster Care in a system outside of California. I was previously in Foster Care in California and aged out of I was previously in Foster Care outside of California and aged out or or emancipated from the system. emancipated from the system. I was previously in Foster Care, but did not age out or emancipate from the system. 2
18. RESIDENCY (required) Self or Parent/Legal Guardian I am or will be at least 19 years of age OR married as of the start of the semester. I am or will be under 19 years of age AND unmarried as of the start of the semester. Parent / Legal Guardian Name: Check: (M) Mother (F) Father (G) Legal Guardian Yes No For Parent: Has your parent claimed you as a dependent on his/her most recent California Income Tax return? Yes No For Legal Guardian: Have you lived continuously with this person for the last two years?
(If under 19 and unmarried, MUST provide permanent address of parent/legal guardian.)
Permanent Address: Phone Number: ( _) -
Answer the following questions. If you are under 19 and unmarried, answer for your parent or legal guardian. Yes No Are you (or parent/legal guardian) a full-time employee, spouse, or dependent of a full-time employee of any of the following colleges/universities? *CA Community Colleges *CA State University or College*University of CA * Maritime Academy
Yes No Are you (or parent/legal guardian) a full-time credentialed employee of a California public school enrolling in college for purposes of fulfilling credential related requirements.
Yes No Have you (or parent/legal guardian)been employed as a seasonal agricultural worker for at least a total of two months of each of the past two years?
During the past two (2) years, have you (or parent/legal guardian): Yes No If yes, year: ______Declared residency in anohter state for state income tax purposes? Yes No If yes, year:______Voted or registered to vote in another state? Yes No If yes, year: ______Declared residency at an out-of state-college or university? Yes No If yes, year:______Petitioned for a lawsuit or a divorce as a resident in another state?
Student’s Military Services Status Student’s Parent (or Guardian) Military Service Status: None apply to me None apply to my parent or guardian Currently serving on Active Duty Parent (or Guardian) Currently Serving on Active Duty Veteran Parent (or Guardian) is a Veteran Member of the Active Reserve Parent (or Guardian) is a Member of the Active Reserve Member Active of the National Guard Parent (or Guardian) is a Member of the National Guard
*If you are currently active in the U.S. Military, or you were discharged within the last year, answer the questions below for yourself. *If you are a dependent spouse or child of an active member of the U.S. military, answer the questions below about your spouse or parent in the military. State of legal residence (military): ______Are you currently stationed in California Yes No Home of record:______Country of Record:______
The Family Educational Rights and Privacy Act (FERPA) is a Federal law that protects the privacy of student education you may at the time of enrollment, direct the college to withhold release of directory information to persons not employed by the college. Subsequently, you may notify the Dean of Student Affairs if you wish to reverse your choice. Directory information at this college includes your name, degrees and awards, and Dean's List recognition, and participation in officially recognized activities and sports, including weight, height, and high school of graduation of athletic team members.
Do you give Hartnell College permission to release your directory information? [ ] YES [ ] NO
I hereby swear under penalty of perjury and college disciplinary action that the information submitted on this document is complete and accurate. I understand all materials submitted by me for purposes of admission become property of Hartnell Community College. I further understand that falsification, withholding pertinent data, or failure to report changes in residence may result in dismissal.
Applicant’s Signature:______Date:______
It is the policy of Hartnell College that there will be no discrimination or harassment on the grounds of race, color, sex, marital status, religion, national origin, age or disability in any educational programs, activities or employment. Persons having questions about equal opportunity and nondiscrimination should contact the Vice President of Student Affairs at (831) 755-6822, Student Services Building Room 123.
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HIGH SCHOOL CODES 3195 Alisal High 3199 Greenfield High 3219 Mt. Toro Continuation 365010 Rancho San Juan 5013 Santa Cruz High 3222 Anzar High 3200 King City High 3201 North Monterey County High 3205 Salinas High 365009 Wellington Smith School 3223 Carmel High 3225 King City Adult 365003 No. Mo. Co. Evening/Indep. 3221 Salinas Adult 146923 Other California High School 364017 Carr Lake Comm. School 54769 Millenium Charter 3202 North Salinas High 3205 Soledad High 146924 Out of California High School 3196 Central Bay Continuation 211572 Mission Trails ROP 3203 Notre Dame High 272622 Soledad Adult School 146925 Foreign High School 3197 Everett Alvarez High 365000 Monterey Co. Home Charter 5014 Pacific Grove High 365007 Soledad Transition Center 165748 Home School 338218 El Puente 365002 Monterey Co. Spec. Ed. 365004 Pinnacles Acad. Charter 365008 Somavia High 245182 Monterey County Middle Schools 3224 Gilroy High 3226 Monterey High 3220 Pinnacles Cont. High 3227 San Benito High 245185 Other CA Middle Schools 3198 Gonzales High 5011 Monterey Evening Adult 365006 Portola Butler Cont. High 5012 Santa Catalina 255362 MCOE Alternative Education 364999 Gonzales Evening COLLEGE CODES
Community Colleges 5069 San Jose City College 3099 CSU Los Angeles 5085 UC Davis 3182 Heald College-San Jose 0408 Cabrillo College 5103 West Hills College 5260 CSU Monterey Bay 5087 UC Irvine 5029 Monterey Institute of Intl. Studies 3107 Chabot College CA State Universities 3100 CSU Northridge 5088 UC Los Angeles 5036 Naval Postgraduate School 3127 Cuesta College 3046 CSU Bakersfield 3101 CSU Sacramento 255351 UC Merced 5072 Santa Clara University 3131 De Anza College 3045 Cal Poly Pomona 3102 CSU San Bernardino 5089 UC Riverside 5054 St. Mary’s College 3165 Evergreen Valley College 3044 Cal Poly San Luis Obispo 5059 CSU San Diego 5090 UC San Diego 5082 Stanford University 3168 Fresno City College 3047 CSU Chico 5062 CSU San Francisco 5091 UC San Francisco 5097 University of San Francisco 3171 Gavilan College 3048 CSU Dominguez Hills 5070 CSU San Jose 5092 UC Santa Barbara 5098 University of Southern California 3176 Hartnell College 3093 CSU Fresno 5080 CSU Sonoma 5093 UC Santa Cruz 5099 University of the Pacific 5027 Mission College 3094 CSU Fullerton 3103 CSU Stanislaus 147054 Other CA College Private College/Univ. 3097 CSU East Bay 147055 Out of CA College 5030 Monterey Peninsula College University of California 5038 Ohlone College 3183 CSU Humboldt 343656 Brandman University 147056 Foreign College 5052 Sacramento City College 3098 CSU Long Beach 5084 UC Berkeley 3181 Heald College-Salinas ACADEMIC PROGRAMS/MAJORS
AA: Associate of Arts Degree AS: Associate of Science Degree CT: Certificate of Achievement AA.ADD Addiction Studies AS.AAT Advanced Automotive Technology CT.ADD Addiction Studies AA.ALC Alcohol and Drug Abuse Counseling AS.ADJ Administration of Justice CT.ADJ Administration of Justice AA.CHC Chicana/Chicano Studies AS.ADT Advanced Diesel Technology CT.AGR Agriculture Business AA.CHCX Chicanx Studies AS.AGR Agriculture Business Emphasis CT.AGRP Agriculture Production AA.DA Digital Arts AS.AGRI Agriculture With an Area of Emphasis CT.AGFS Agriculture-Food Safety AA.GSE General Studies-Ethnic Groups in the US Emphasis AS.AGRP Agriculture-Production CT.ALC Alcohol and Drug Abuse Counseling AA.GSH General Studies - Humanities Emphasis AS.AST Astronomy CT.BIW1 Business Information Worker Level-1 AA.GSL General Studies - Language & Rationality Emphasis AS.BIO Biology CT.BIW2 Business Information Worker Level-2 AA.GSN General Studies - Natural Sciences Emphasis AS.BST Business Office Technology-Info Processing CT.BOTB Business Office Tech - Bookkeeping AA.GSS General Studies - Social & Behavioral Science Emphasis AS.CMA Construction Management & Architecture CT.BST Business Office Tech-Info Processing AA.LAA Liberal Arts-Anthropology Emphasis AS.CISCS CSIS-Computer Science Option CT.CISC CSIS-Computer Science Option AA.LACS Liberal Arts-Culture & Society Emphasis AS.DWD CSIS-Digital & Web Design Option CT.PCN CSIS-Network & Security option AA.LAHU Liberal Arts-Humanities Emphasis AS.DWMD CSIS-Digital Wed & Mobile Development CT.CSUGE CSU General Ed Breadth AA.LAL Liberal Arts-Languages & Literature Emphasis AS.PCN CSIS-Network & Security option CT.DA Digital Arts AA.LAP Liberal Arts-Psychology Emphasis AS.ECE Early Childhood Education CT.ECE Early Childhood Education AA.LAPS Liberal Arts-Political Science Emphasis AS.EGN Engineering CT.IGETC IGETC AA.LAS Liberal Arts-Sociology & Social Sciences Emphasis AS.KIN Kinesiology CT.MD CSIS-Mobile Development Option AA.LPH Liberal Arts - Philosophy Emphasis AS.MFGT Manufacturing Technology CT.NVN Nursing (Vocational) AA.MUS Music AS.NRN Nursing (Registered) CT.PHO Photography AA.PHO Photography AS.PE Physical Education - Kinesiology CT.WD CSIS-Web Development Option AA.PSY Psychology AS.RCP Respiratory Care Practitioner CT.WLD Welding Technology AA.SPA Spanish AS.WLD Welding Technology AA.SSC Social Sciences AST: Associate of Science for Transfer Degree AA.TAC Theatre Arts & Cinema AST.AGR Agriculture Business for Transfer (AS-T) AST.ADJ Administration of Justice for Transfer (AS-T) AAT: Associate of Arts for Transfer Degree AST.APS Agriculture Plant Science for Transfer (AS-T) AAT.COM Communication Studies for Transfer Degree (AA-T) AAT.POL Political Science for Transfer (AA-T) AST.BIO Biology for Transfer Degree (AS-T) AAT.ECO Economics for Transfer Degree (AA-T) AAT.PSY Psychology for Transfer (AA-T) AST.BUS Business Administration for Transfer (AS-T) AAT.ENG English for Transfer (AA-T) AAT.SJ Social Justice for Transfer (AA-T) AST.CHM Chemistry for Transfer Degree (AS-T) AAT.ETP Elementary Teacher Education for Transfer (AA-T) AAT-SOC Sociology for Transfer (AA-T) AST.CS Computer Science for Transfer (AS-T) AAT.HIS History for Transfer (AA-T) AAT.SPA Spanish for Transfer (AA-T) AST.ECE Early Childhood Education for Transfer (AS-T) AAT.KIN Kinesiology for Transfer (AA-T) AAT.SART Studio Arts for Transfer (AA-T) AST.FTVE Film, Television and Electronic Media (AS-T) AAT.LAW Law, Public Policy and Society (AA-T) AAT.THA Theatre Arts for Transfer (AA-T) AST.GEL Geology for Transfer Degree (AS-T) AAT.MUS Music for Transfer (AA-T) AST.MAT Mathematics for Transfer Degree (AS-T) AST.PHY Physics for Transfer (AS-T) AST.PHS Public Health Science for Transfer (AA-T)
Revised 10-05-2020
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