CCSF Noncredit Application

NON-CREDIT APPLICATION FOR ADMISSION
三藩市市立大學非學分課程入學申請表
50 Phelan Avenue, Smith Hall, Room 118B, San Francisco, CA. 94112

PLEASE COMPLETE THE ENTIRE APPLICATION IF YOU ARE A NEW STUDENT. 如果你是新同學，請填妥整份表格
(Input must be typed in English. 注意﹕所有的資料必須要用英語輸入)

Semester: 學期年

Fall 秋季

Spring 春季

Summer 夏季

Campus you would like to attend: 你申請讀下列那間分校
Alemany Downtown Mission
Chinatown/North Beach Evans Ocean Ave.
Castro/Valencia John Adams Southeast

1. IDENTIFICATION 身份

Student ID / Social Security Number 學生証 / 工咭號碼 - -
(Optional)
Be sure your Social Security Number is accurate as it is used as part of your permanent record. If you do not have a Social Security Number, leave blank and you will be assigned a Student Identification Number
(可填或不填)
請填上正確的工咭號碼﹐ 因為它將會成為你的永久檔案的一部分。如果你沒有工咭號碼請留空你將被分配一個學生證號碼。
Last Name 姓
First Name 名 Middle
Email 電子郵件
Previous Name
Last Name 曾用過姓
First Name 名 Middle
Mailing Address 通訊地址
Number and Street 門牌及街名 Apt. # 柏文號碼
City 市 State 州 Zip Code 郵區號碼 -
Permanent Address 永久地址 (if different)
Number and Street 門牌及街名 Apt. # 柏文號碼
City 市 State 州 Zip Code 郵區號碼 -
Home Phone 住宅電話 () - Work Phone 工作電話 () -
Sex 性別 Male 男 Female 女 Birthdate: 生日
Contact via / 聯絡通過:
Email / 電子郵件 Phone / 電話 U.S. Mail / 郵件
Text messaging (Standard text messaging rates apply)
   / 正文消息 (標準正文消息率申請)
      Cell phone number / 手機號碼: - -
      Cell phone provider / 手機提供者:

2. ETHNICITY 種族

What is your Ethnicity? 你的種族

3. VOTER REGISTRATION 選民登記

I am a U.S. citizen and want to register to vote, or I have recently moved and need to re-register.
Please send me voter registration/education information.
我是美國公民和想登記投票，或我最近搬了和需要重新登記。
請寄给我選民登記表格/選舉资料。 Yes 是   No 否

4. EDUCATION 教育

What is your long term Educational Goal? 你的長遠教育目標？

What is the Highest Educational Level You Have completed? 你已達到的最高教育程度？

Year Received 畢業年份
Is English Your Primary Language? 英語是否你的母語？ Yes 是   No 否

5. EMERGENCY CONTACT 緊急事聯絡人

Last Name 姓 First 名 Phone 電話 () -
Number and Street 地址ー門牌及街名 Apt. # 柏文號碼
City 市 State 州 Zip Code 郵區號碼 -

6. NON-DISCRIMINATION POLICY 非歧視政策

All programs and activities offered by City College of San Francisco shall be performed in a manner which is free of discrimination on the basis of race, color, national origin, ancestry, religion, creed, sex, pregnancy, marital status, sexual orientation, disability or veteran status. 任何人仕，不論種族、膚色、國籍、祖籍、宗教、信條、性別、懷孕、婚姻狀況、性傾向、