SCE Preregistration Survey_Fall2012


A red asterisk (*) indicates required questions.

  1. Last Name*


  1. First Name*


  1. Student ID*


  1. Date of Birth (mm/dd/yyyy)


  1. Student Email*


  1. Home Phone


  1. Student Cell Phone


  1. Address


  1. Parent(s) Name(s)


  1. Parent Email


  1. Parent Phone


  1. SCE First Choice
    Internship Capstone
    Independent Capstone


  1. SCE Second Choice
    Internship Capstone
    Independent Capstone


  1. SCE Field of Interest


  1. SCE Potential Mentor/Placement