Fillable COLUMBIA COLLEGE/MODESTO JUNIOR COLLEGE CONCURRENT ENROLLMENT FORM FOR (Modesto Junior College)

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COLUMBIA COLLEGE/MODESTO JUNIOR COLLEGE CONCURRENT ENROLLMENT FORM FOR (Modesto Junior College)

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COLUMBIA COLLEGE/MODESTO JUNIOR COLLEGE
CONCURRENT ENROLLMENT FORM FOR
CONTINUING STUDENTS
Please submit completed form via email to ONE of the campuses listed below.
Today’s Date:
College Currently Attending: MJC CC
Student Information:
First Name: Middle Initial: Last Name:
Student ID: w Birthdate: Phone Number:
Term/Year of Intent (Select One): Fall Spring Summer
Student Signature: Date:
Oce Use Only
High School Student: Yes No Local Units Earned: Currently Enrolled in Units
Appointment Date: Appointment Time: Level:
Sta Initials: Posted Date: Matriculation Met: Student Notied: Date:
Notes:
Send to:
Columbia College
Email: ccadmissions@yosemite.edu
Fax: (209)588-5337
Phone: (209)588-5231
Modesto Junior College
Email: MJCESeForms@mjc.edu
Fax: (209)575-6859
Phone: (209)575-6853
03/2020_SJB
MJC Enrollment Services • Phone (209) 575-6853
EAST Campus, 435 College Avenue, Student Services Bldg. 1st Floor • West Campus, 2201 Blue Gum Avenue, Yosemite Hall, Room 147 - 1st Floor
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COLUMBIA COLLEGEMODESTO JUNIOR COLLEGE CONCURRENT ENROLLMENT FORM FOR (Modesto Junior College)

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Completed 4 September 2020

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