Migrant Services Application

Identification

Permanenent Address

Local Address

Personal Information
Birth Date


Birth Place
    


Gender
         


Ethnic Background
     
           


Participated in Migrant Ed?
       


(CAMP,MEP,HCOP,EOP,UB,SSS,etc.)




Student Information

Goals:



Expected Fresno State:

Education:


Family Information

Parental Occupations


  
Is your Father a farmworker?
   
       


  
Is your Mother a farmworker?
   
       



         

Family Income?
 
 
 
 
     




Has anyone in the family graduated from College?
           

Miscellaneous Information
What is your college level?


Do you qualify for financial aid?
           


Do you own a computer?
           


Do you have Internet access at home?
           


Are you a transfer student?
           


Were you a member of the Migrant Education Program K-12?
           


Were you a member of CAMP?
           


Were you a member of the EOP?
           


Were you a member of the HCOP?
           


Were you a member of the MEP?
           


I understand that it may be necessary for UMS to access my university confidential records. I grant my permission for UMS to access my confidential records.