Westchester Community College, State University of New York

Educational Opportunity Program Application

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Personal Information

Full Name *

WCC Student ID # *

Mailing Address *

City *

State *

Zip

Home Phone

Cell Phone *

Email *

Sex

Please provide

Age

Date of Birth

Please indicate (x) if you are or were a *

New EOP Student

EOP Transfer Student

HEOP Transfer Student

SEEK Transfer Student

College Discovery Transfer Student

Race /Ethnic Data *

Caucasian/White (Not Hispanic)

African American/Black (Non-Hispanic)

Asian

Hispanic or Latino

Pacific Islander

American Indian or Alaskan

Native Hawaiian/Other Pacific Islander

Multi Racial

Financial Data

Household Income: *

Household Size: *

number of people in your home

Public Assistance Income: *

Social Security Income: *

Are you a WARD of State *

Yes

No

Are you in Foster Care *

Yes

No

Academic Data

Interested in attending WCC *

Full Time

Part Time

Intended Major *

High School Name *

Graduation Date *

H.S. Average *

GED (Date)

Please write a personal statement as to why you would like to join the Educational Opportunity Program *

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