Butte College

Butte-Glenn Community College District, 3536 Butte Campus Drive Oroville, CA 95965-8399

Application for Admission to the College

Welcome to Butte College. Whether you are preparing for transfer to a four-year college or university, seeking an occupational degree or certificate, or taking classes to improve skills or investigate a new career, we are pleased that you have chosen to attend Butte College. Our staff is committed to providing you with the best education possible. mathematics if prior course work meets the necessary criteria. No previous academic work may be disregarded. Request your former school(s) to send an official transcript (any other copies are unacceptable) of your records to Butte College at the address shown above. (Call your prior college(s) to find out the charge for transcripts.) These transcripts become part of your permanent file and will not be released or forwarded to other institutions.

Admission Procedures
All applicants are urged to complete the admission process as early as possible. All new students need to complete this application form. Processing time for your application is 4-6 working days. To obtain your Butte College I.D. number visit our website at webadvisor.butte.edu/webadvisor/getnewid.jsp. You are considered a new student if you have not previously enrolled at Butte College. You are considered a returning student if you have previously enrolled but have been away from Butte College for a semester or more. Please check the class schedule for registration information. If you have graduated from high school since you last attended Butte College, you need to fill out a new application. This Application for Admission Form must be completed and signed in the students own handwriting. Be sure to fill in all sections, front and back. Butte College admits all high school graduates or the equivalent, and any person 18 years of age or over who is capable of profiting from the instruction offered.

No Application Fee
There is no charge to apply for admission, and the application does not require you to enroll; it just gives you the option. Once an application has been submitted and processed, you will receive: 1- A postcard regarding receipt of your application, 2- A letter from the Admissions Office outlining the pre-enrollment activities, and 3- A letter from the Orientation Office on how to obtain an Orientation appointment.

Assistance for Students

Butte College is committed to assist students in their college experience. We provide the START program which covers pre-enrollment procedures. This program assists students beginning at Butte College, staying in college, and going on to another college or into jobs of their choosing.

College Transcripts are Required

Transcripts of all previous academic work are required for students who enroll in credit courses and for students who will be receiving financial aid/ veterans benefits. Students may be exempt from assessment for English, reading, and/or

Enrollment Restrictions, Assessment & Orientation

Students have enrollment restrictions until they have been assessed for English, reading, and mathematics, have had an Orientation to the College, and have had pre-enrollment counseling/advising. You will receive more information regarding the START program after we receive your completed application.

DESCRIPTION OF STUDENT SERVICES

Information can be obtained by contacting the following offices.

(NOTE: All phone numbers are in the 530 area code) at least six units. (895-2311) Health Services - Available to all registered students. A registered nurse, doctor, and family planning nurse practitioner can be seen on campus by appointment. (895-2441) International Student Advising - Located in the Counseling Office, providing information on immigration regulations, transfer programs, general education requirements and personal counseling. (895-2378) Learning Disability Assistance - Individual support services, including one-to-one tutoring, are available for students qualifying with a specific learning disability. Any student experiencing persistent difficulties with reading, writing, spelling, arithmetic or memory should contact the Learning Disability Specialist. (895-2455) Orientation - Orientation is a program designed to familiarize students with college policies and procedures as well as campus locations. (895-2416) Re-Entry Student Services - Available to men and women of all ages who are returning to school after an absence. It is designed to help students make a successful transition to campus life. (895-2396) Students Activities - Program includes campus clubs and organizations, student government, public events, and more. (895-2427) Study Skills Assistance - Study skills workshops are offered occasionally in the Tutorial Learning Center. (895-2386) Transfer Assistance - Consult with a counselor for program planning and preparation for entrance to a four-year college or university. (895-2264) Tutoring in Basic Skills/Other - Tutoring is available in reading, English, math and other subject areas. Conducted in a group setting, it is free of charge. (895-2386) Veterans Programs - A variety of assistance programs are available to veterans and their dependents through the Veterans Office. (895-2556) Work Experience - Through the Cooperative Work Experience Program, students may receive units of credit for learning while working. (895-2334) 10/2004

Admissions & Records - Enrollment applications and Student Records. (895-2361) Assessment - Assessment is the measurement of students' reading, writing and math skills. The results are used in establishing placement levels and eligibility for basic skills classes. (895-2350) Athletics-Intercollegiate Competition - Information about intercollegiate sports and athletic advising may be obtained. (895-2521) Cal WORKS - A program that provides support services for TANF recipients who are in pre-approved education and training. (895-2340) Career Planning - Individual appointments, classes, and workshops are offered by the Career Center to assist in identifying a major and/or career goal. (895-2340) Child Care- Information and referrals regarding child care and attending college are provided by New Horizons (895-2396) and EOPS (895-2555) Programs. Counseling - Day and evening services are available to assist students with selection of classes, choice of majors and/or careers and other concerns. (895-2378) Disabled Students Programs & Services - Assistance with registration, mobility needs, note-taking, and a variety of support services are provided. (895-2455) Employment Assistance - The Placement Center provides part-time and full-time employment information to students and graduates. (895-2334) English Language Assistance - There is an English as a Second Language (ESL) Program available through the college. There are seven levels of instruction covering conversation, reading, and writing skills. (895-2378) Extended Opportunity Programs and Services - A state funded program providing services such as: professional counseling, financial aid and academic advising, oneto-one tutoring, free typing and a variety of other support services. Eligibility determined by income and educationally disadvantaged circumstances. (895-2555) Financial Aid - Federal and state money available for qualified students enrolling in

TABLES AND CODES FOR USE IN FILLING OUT THIS APPLICATION

TABLE 1 - Academic Programs Codes:
01308 07269 01298 11137 01301 01377 01323 01306 01326 01314 01315 01313 01307 01310 11128 01358 01322 01346 01318 01319 11138 01370 11136 11139 Accounting Admin of Justice Agri Science Agri & Natural Resources Agri Business Alcohol & Drug Studies Automotive Technology Biological Science Building Inspection Tech Bus Legal Office Asst Bus Medical Front Office Asst Bus Admin Office Asst Business Administration Business Management Ceramics Chemistry Civil Engineering Tech Clothing & Textiles Computer Applications Computer Info Systems Computer Science Cosmetology Court Personnel - Prelaw Dietetics & Food Admin AS, CA AS, CA AS, CA AS AS AS, CA AS, CA AS AS, CA AS, CA AS, CA AS, CA AS AS, CA AA, CA AS AS, CA AS AS, CA AS, CA AS AS, CA AS, CA AS 01324 01349 01343 01321 07258 01344 07467 01348 01329 01362 01320 11140 07264 07260 01345 01302 11131 01372 11133 01339 01311 01355 01305 11124 Drafting & CAD Tech Early Childhood Education Emer Med Tech/Paramedic Engineering Environmental Horticulture Family & Consumer Sci Fashion Comm & Marketing Fashion Merchandising Fine Arts Fire Technology General Physical Education Graphic Design Graphic Design for Print Heavy Equip Op Tech Interior Design Landscape/Turf grass Tech Language Arts Liberal Studies Liberal Studies Bilingual LVN to ADN Marketing Mathematics Mechanized Agriculture Medical Transcription AS, CA AS, CA AS, CA AS AS, CA AS, CA AS, CA AS, CA AA AS, CA AA AA AS CA AS, CA CA AA AA AA AS, CA AS, CA AS AS, CA CA 09582 07259 14557 07257 01304 01334 11126 01356 01357 11142 07466 07470 07474 01312 14583 01342 11123 11122 01363 01371 07271 07266 01340 01325 Multimedia Studies Natural Resources Nonstructural Plan Checking Nursery/Florist Tech Parks & Recreation Photography Phys Ed/Exercise Physiology Physical Science Physics Radio-TV Film Radio-TV Film/Agri Comm Radio-TV Film/Media Sales & Mgmt Radio-TV Film/Radio Prod Real Estate Registered Nursing Respiratory Care Retail Management Small Bus/Entrepreneurship Social & Behavioral Science Tourism & Travel University Studies Visual Merchandising Vocational Nursing Welding Technology AS, CA AS, CA AS CA AS, CA AS AA AS AS AS AS, CA AS, CA AS AS, CA AS AS, CA AS AS AA AS, CA AA AS, CA AS, CA AS, CA

AS = Associate in Science Degree; AA = Associate in Arts Degree; CA = Certificate of Achievement

TABLE 2 - HIGH SCHOOLS IN BUTTE DISTRICT

3001822 3314523 3000565 3000965 3002230 3000226 3312718 3001489 Biggs Challenge Charter Chico Sr. Durham Fairview Gridley Hamilton Las Plumas 3001550 3002381 3001115 3000723 3001341 3001993 3312735 3313091 Orland Oroville Paradise Adventist Paradise Pleasant Valley Prospect Ridgeview Willows 3000027 3314279 Out of California Out of United States

TABLE 3 - CALIFORNIA COMMUNITY COLLEGES

3001478 3001459 3002349 3000296 3001336 3000299 3000337 3001473 3001487 3000703 3000309 3001347 3001572 3000688 3000325 3000938 3000701 3001472 3000418 3002369 3002370 3001088 Alameda Allan Hancock American River Antelope Valley Bakersfield Barstow Butte Cabrillo Canada Canyons Cerritos Cerro Coso Chabot Chaffey Citrus Coastline Columbia Compton Contra Costa Cosumnes River Crafton Hills Cuesta 3001129 3001980 3000714 3001975 3001102 3001605 3001490 3000371 3001609 3000717 3000778 3002383 3000386 3002386 3000006 3002001 3000334 3002004 3000392 3001415 3001121 3001622 Cuyamaca Cypress De Anza Desert Diablo Valley East Los Angeles El Camino Evergreen Valley Feather River Foothill Fresno City Fullerton Gavilan Glendale Golden West Grossmont Hartnell Imperial Valley Indian Valley Irvine Valley Lake Tahoe Laney 3000168 3000726 3001671 3002393 3002008 3000730 3001168 3002057 3002009 3001601 3000343 3001991 3000747 3001518 3001718 3001644 3000539 3002407 3001517 3001637 3002020 3002022 Las Positas Lassen Long Beach City LA City LA Harbor LA Mission LA Pierce LA Southwest LA Trade-Tech LA Valley Los Medanos Marin Mendocino Merced Merritt Mira Costa Mission Modesto Monterey Peninsula Moorpark Mt San Antonio Mt San Jacinto 3001672 3002419 3000368 3000755 3000737 3002037 3000759 3000374 3000711 3000767 3001661 3002047 3001662 3001709 3001163 3002051 3000425 3000441 3000690 3001700 3002052 3000306 3001551 3000775 3001602 3000116 3000796 3002107 Napa Valley Ohlone Orange Coast Oxnard Palo Verde Palomar Pasadena City Porterville Redwoods Reedley Rio Hondo Riverside City Sacramento City Saddleback San Bernardino Valley San Diego City San Diego Mesa San Diego Miramar San Francisco City San Joaquin Delta San Jose City San Mateo San Francisco San Jose San Luis Obispo Polytech San Marcos Sonoma Stanislaus 3001552 3002441 3000389 3001166 3001082 3000390 3001167 3002378 3001595 3001193 3000022 3000016 3001697 3002084 3001322 3002357 3000035 3001585 3000423 Santa Ana Santa Barbara City Santa Monica Santa Rosa Sequoias Shasta Sierra Siskiyous Skyline Solano Southwestern Taft Ventura Victor Valley Vista West Hills West Los Angeles West Valley Yuba

CALIFORNIA STATE UNIVERSITIES AND COLLEGES

3001502 3001464 3001469 3001607 3002422 Bakersfield Chico Dominguez Hills Fresno Fullerton 3000712 3002002 3002058 3001555 3000899 Hayward Humboldt Long Beach Los Angeles Monterey Bay 3002086 3002362 3002059 3002364 3000387 Northridge Pomona Polytech Sacramento San Bernardino San Diego

OTHER THAN ABOVE UNIVERSITY OF CALIFORNIA

3002106 Hastings College of Law 3000405 Berkeley 3001179 Davis 3000054 Irvine 3000406 Los Angeles 3001181 Riverside 3002071 3001326 3001568 3000798 San Diego San Francisco Santa Barbara Santa Cruz 3313065 3314280 Out of California Out of United States

Butte College
3536 Butte Campus Drive Oroville, CA 95965-8399

YOU MUST COMPLETE ALL ITEMS PLEASE PRINT COMPLETE BOTH PAGES

I.D. Number OFFICIAL USE ONLY

Mark the term that reflects your first semester of enrollment.

You do not need to complete another application if you have previously taken Butte College courses. (Except K-12 students)

Summer 20____

Fall 20____

Winter Session 20____

Spring 20____

LEGAL NAME AS IT APPEARS ON YOUR SOCIAL SECURITY CARD Please notify the Admissions and Records Office each time you change your address.

LAST NAME PREVIOUS NAME USED ON ACADEMIC RECORDS MAILING ADDRESS & Apt.# CITY TELEPHONE ( )

SUFFIX

FIRST NAME

MIDDLE INITIAL

COUNTY

STATE TELEPHONE ( )

ZIP CODE

HOME

CELL

HOME

2
CELL

GENDER

MALE

FEMALE

BIRTHDATE

SOCIAL SECURITY NUMBER

/
MONTH DAY

/
YEAR

PREDOMINANT ETHNIC BACKGROUND (REQUIRED TO COMPLETE) F.-Filipino PG-Guamanian PH-Hawaiian H-Hispanic HX-Hispanic, Other AJ-Japanese AK-Korean AL-Laotian HM-Mexican/Chicano

ENTER APPROPRIATE LETTER IN BOX

MUST BE ACCURATE If you are enrolling for credit, your Social Security number is requested to verify your identity for accurate record keeping. Providing the number is voluntary.

6 7

E-MAIL ADDRESS Print Clearly

ACADEMIC PROGRAM (Program of study you intend to pursue at Butte College)

ACADEMIC PROGRAM CODE: See Code Sheet on previous page.(Table 1) Select Degree (A) or Certificate (C) Use 5 digits plus 1 letter. Example:

N.-American Indian/ Alaskan Native A.-Asian AI-Asian Indian AX-Asian, Other B.-Black (Non-Hispanic) AM-Cambodian HR-Central American AC-Chinese

O.-Other Non-White P.-Pacific Islander PX.-Other Pacific Islander PS-Samoan HS-South American AV-Vietnamese W.-White (Non-Hispanic) XD-Decline to State

1 3

0 8

EDUCATIONAL GOALS (REQUIRED TO COMPLETE)

ENTER APPROPRIATE LETTER IN BOX

10

STUDENT EDUCATION STATUS (REQUIRED TO COMPLETE) (Highest level of education) College graduates fill out both boxes HIGH SCHOOL GRADUATE: ENTER 1 Received a High School Diploma APPROPRIATE NUMBER IN BOX 2 Received GED or Certificate of Equivalency/Completion (1-7 ) 3 Received Certificate of High School Proficiency Exam PRIMARY LANGUAGE 11 MILITARY 4 Foreign High School Diploma/Certificate IS ENGLISH YOUR PRIMARY 1. None Apply DID NOT GRADUATE: SPOKEN LANGUAGE? 5 Special Admit student currently enrolled in K-12 2. Active Military YES = English 6 Not a graduate of, and no longer enrolled in high school ENTER APPROPRIATE 3. Dependent of Active Military 7 Currently enrolled in Adult School NUMBER IN BOX (8 - 9) 4. Discharged within the last year NO = Not English COLLEGE GRADUATE: 5. Discharged over a year ago (Veteran) 8 Received an Associate Degree YEAR COLLEGE 9 Received a Bachelor Degree or higher DEGREE RECEIVED: HIGH SCHOOL EXPERIENCE Enter the high school code from which you graduated, attended without graduating, or are currently attending (see code sheet - Table 2) If your school is not listed, please include the name of your high school in the space provided. Other High School Calendar Years Attended from City State If you are currently in high school, please fill in your anticipated graduation date: Month [ HIGH SCHOOL CODE

A - Obtain an associate degree and transfer to a 4-year institution B - Transfer to a 4-year institution without an associate degree C - Obtain a two year associate's degree without transfer D - Obtain a two year vocational degree without transfer E - Earn a vocational certificate without transfer F - Discover/formulate career interests, plans, goals G - Prepare for a new career (acquire job skills) H - Advance in current job/career (update job skills) I - Maintain certificate or license (e.g. Nursing, Real Estate) J - Educational development (intellectual, cultural) K - Improve basic skills in English, reading or math L - Complete credits for high school diploma or GED M - Undecided on goal

ARE YOU A U.S. CITIZEN? Yes No If no, write what country you are a citizen of and check the box that indicates your status. 2. Permanent Resident Visa (Alien Number: 3. Temporary Resident 4. Refugee/Asylee Status 5. Student Visa Status (F-1 or M-1) 6. Other Status (Specify: )(Date Issued )

) (Date I-94 expires:

12

13

to

Year [

14

COLLEGE EXPERIENCE List all colleges attended, most recent or currently attending first. Send transcripts to Admissions and Records Office.

College/University City & State/Country From To Units Earned Code from Table 3, if listed

College/University City & State/Country From To Units Earned Code from Table 3, if listed

College/University City & State/Country From To Units Earned Code from Table 3, if listed
10/2004

STATEMENT OF LEGAL RESIDENCE

PART I
ALL STUDENTS TO COMPLETE THIS SECTION
No
A. Have you lived in California for the last 2 years? Yes B. Do you intend California to be your permanent residence? Yes No C. Did you file California State Income Tax the last two years? Yes No If No, did you file last year? Yes No D. Are you a public school credentialed employee or an on-duty California peace officer? 1. If No, list the states (do not use USA) or countries that you have lived in for the past two years including California. State/Country from to (Required)
mo/day/yr mo/day/yr

Yes No
Date issued

E. Are you a seasonal agricultural employee or dependent? Yes No F. Do you have a current driver's license or I.D. card? State G. Is your vehicle currently registered? State Date issued Date registered

State/Country from
mo/day/yr

to
mo/day/yr

(Required)

H. Are you currently registered to vote? State I. Other proof of residency in California

2. Proceed to Questions B through I

PART II

ALL STUDENTS UNDER 19 YEARS OLD PLEASE COMPLETE

A. Are you married? Yes No If Yes, go to Part III. If No, and you wish to be considered for residency, you must check either #B or #C and completely fill out the information listed below the letter. C. I have lived on my own or with someone other than my parent(s) B. I have lived continuously for the past two years with one or both at some point during the past two years. In order to be considered a of my parents and he/she/they have lived in California continuously for California resident, you must answer the following questions about the past two years. your parents: Did he/she file California State Income Tax the last two years? Yes No If No, did he/she file last year? Yes No Does he/she have any of the following? Driver's License or I.D. card ..... State Vehicle Registration ......... State Zip Code Registered to vote ............ State Other proof of residency in California: Date Issued Date Issued Date Registered

Check one: Both Parents Parent Name(s) Address City State

Mother

Father

PART III

TO BE COMPLETED BY MILITARY PERSONS, DEPENDENTS, OR VETERANS DISCHARGED WITHIN THE LAST YEAR
Yes No ACTIVE DUTY MILITARY PERSONS AND/OR DEPENDENTS MUST provide a statement from the Commanding Officer that assignment to California is not for educational purposes and the date of assignment to California. DEPENDENTS must also provide a letter that they are dependent of a military person for Federal tax exemption.

A. Are you an active member of the military? If No, separation date?

mo/day/yr

B. Are you a dependent of an active military person?

Yes No

C. When did your tour or sponsor's tour begin in California? D. What is your State of legal residence on military records?

PART IV

SELECTIVE SERVICE

If you are a male U.S. Citizen living in the United States whose age is between 18 and 25 you have an obligation to register in accordance with the federal Military Selective Service Act (50 U.S.C. App.451 et seq.). Additional information can be obtained at the U.S. Post Office or at the web site of the Selective Service whose URL is http://www.sss.gov/Welcome.html.

PART V

TO BE SIGNED BY ALL STUDENTS

I DECLARE UNDER PENALTY OF PERJURY THAT THE STATEMENTS SUBMITTED BY ME ARE TRUE AND CORRECT. All materials submitted by me for purposes of admission become the property of Butte College. I understand that falsification, withholding pertinent data, or failure to report changes in residence may result in my dismissal.

Student's Signature

Date

(INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED) FOR OFFICIAL USE ONLY REVIEWED: date Initials PROCESSED: date initials STUDENT NOTIFIED: date initials