Admissions & Records | Student Submission Form

Admissions & Records | Student Submission Form

Thank you for visiting the Admissions & Records Virtual Front Desk. The Virtual Front Desk is monitored during the following hours: Monday to Friday 8AM to 4PM

STUDENT INSTRUCTIONS

You MUST submit your own forms. No one else may submit a form on your behalf.

Last Name*

First Name*

Date of Birth (mm/dd)

Please ONLY Enter Your Month and Day (mm/dd)

Student ID - A#

Please enter your Student ID number (DO NOT ENTER YOUR SOCIAL SECURITY NUMBER)

Phone*

(###) ###-####

Email*

Current students MUST use their Mt.SAC email address.

Reason*

Please select the general reason that you are contacting the Office of Admissions and Records. I would like to submit a:

Select

Description*

Please describe in detail how we can assist you.

File Attachments*

Please upload the following documents (MUST be in PDF format):

1. A copy of a government-issued ID to verify your identity.

2. The form and documents (if applicable) you received with the email from "FCCC-Mt. San Antonio College".

Drag and drop files here or

Agreement

I hereby swear that I am the student referenced in this submission and that all the information that I provided is true and correct. I also understand that misrepresenting or falsifying any information in this submission is a violation of the Student Code of Conduct and if discovered, I may be reported to the Student Life Office for disciplinary action.*

Checking the box below indicates your agreement to the above statement.

**********

Please check the box below to receive an emailed verification of your electronic submission.

Send me a copy of my responses

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