Welcome Center Interest Form

First Name (required)

Maximum 50 characters

Last Name (required)

Maximum 50 characters

Pronouns (optional)

Maximum 75 characters

Date of Birth (required)

Phone Number (required)

Can we text you? (required)

Yes

No

Email (please avoid using a school email) (required)

Are you currently a high school student? (required)

Yes

No

What school do you attend?

When do you want to start at Clark College?

Start Term

Select Term Winter Term Spring Term Summer Term Fall Term

Start Year

What do you want to study?

Maximum 125 characters

Have you attended Clark College before? (required)

Yes

No

Please send me more information about (check all that apply):

I want to schedule an enrollment appointment!

Athletics

Campus Tour/Visit

Career Exploration

Child Care

Disability Access Center

Diversity Center

Financial Aid/Scholarships

Non-credit Classes

Online Classes and Programs

Placement Information

Running Start

Student Life and Activities

Veterans Resources

Submit