Citrus College Interest Card

Citrus College Interest Card

Complete this form to receive information about Citrus College.

Event Source*

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Student/Parent*

Select

Student Type*

Please select "Recent High School Graduate" if you graduated high school in the last five years. Please select "Nontraditional Student" if you graduated high school more than 5 years ago.

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First Name/Preferred Name*

Last Name*

Date of Birth*

Mailing Address

City

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Zip Code

High School*

If the high school does not appear in the drop down list, please type the name of the school.

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Grade Level*

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High School Graduation Year*

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Email*

Contact Phone Number

Second Contact Phone Number

If different then contact phone number.

Permission to Send Text Message:

Yes

No

Parent Full Name

Parent Email*

Parent Phone

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