2024 SMCCCD Short-Term Faculty-Led Program ApplicationPhilippines

2024 SMCCCD Short-Term

Faculty-Led Program Application

Philippines

Application Date*

Last name*

First Name*

Middle initial

Email*

Phone Number *

Address*

City*

State*

Zip code*

Birth date*

Are you 18 or older?*

Select or enter value

Primary SMCCCD Campus/College attended*

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Student ID (G#)*

Is your current GPA 2.25 or higher?*

Select or enter value

Gender*

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Nationality*

Do you have a valid passport?*

Select or enter value

Passport Number

Passport Expiration Date

Person to contact in case of emergency: First and last name*

Person to contact in case of emergency : Phone number*

Person to contact in case of emergency : Email*

Do you have any special dietary needs?*

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If yes, please specify:

Follow previous question

Do you have any allergies or chronic ailments?*

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If yes, please specify

Follow previous question

Have you ever received counseling or treatment for a nervous or emotional problem?*

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If yes, please specify here

Do you have any special needs which would make it difficult for you to climb stairs or walk long distances?*

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If yes, please specify below

Are you presently taking any prescription medication(s) on a regular basis?*

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Please specify (if yes):

Travel can require a great deal of physical mobility. Do you feel you are able to perform the essential functions of travel in this program with or without any special requirements?*

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If you do have special requirements, describe the requirements you would need and how they would enable you to participate.

Uploading a copy of unofficial transcript*

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Uploading a copy of passport "bio page"*

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Please upload a copy of your unofficial transcript and a copy of your passport "bio page."*

SMCCCD students can receive their unofficial transcripts by logging in to https://websmart.smccd.edu/ and emailing your unofficial transcript to yourself.

Passports are required for all programs. You must obtain your own passport.

We urge you to apply for (or renew) your passport as soon as you have decided to take part in the program. Passport application can take 8-11 weeks to process. For more information about obtaining a passport, visit http://travel.state.gov/passport/. You may also apply for your passport and take passport photos at Skyline College’s Passport Office.

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