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Umoja Application
Personal Information
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Date of Birth
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Gender
Ethnicity
14. Which semester would you like to join Umoja?
SemesterYear
What is your major?
What is your career interest(s)?
What is your educational goal?
Choose one or more
Enrollment Status
Are you or do you plan to be a full-time or part-time student?
Citizenship status
Did you receive financial aid?
Which math and English courses were you placed into?
Math
English
If you are working while attending college:
Where do you work?
How many hours a week do you work?
If you are a current CSM student, what is your current course schedule?
Class name, class time and instructor
If you are a current high school student:
Which high school do you attend?
When will you graduate from high school?
What is your current GPA?
What is your mother’s highest level of education?
What is your father’s highest level of education?
Why do you want to join the Umoja Community?
What is your greatest concern about attending college?
How did you hear about the Umoja Community?
If you were referred by a counselor, professor, or other person, please provide their name.
Do you have any skills, interests, or talents you might consider sharing with other students in the community? If so, what are they?
Are you interested in working in a healthcare profession?
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Date *
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