1. Participant Information:
Sac State Student ID:   Name: Phone Number:   Cellphone Number:   Email Address:   Street Address: City, State & Zip:   Ethnic Identity:	Sac State I.D. number retrieval tutorial First Name MI Last Name ( ) -   ( ) -     , AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY   No Response American Indian / Native American Asian Indian Black/ African American Cambodian Central American Chicano / Mexican American Chinese Cuban Declined to State Filipino Guamanian Hawaiian Japanese Korean Laotian Other (Not Listed) Other Asian Other Hispanic (Not Listed) Other Pacific Islander Other Southeast Asian Puerto Rican Samoan South American Thai Vietnamese White / Caucasian (Optional)
2. Community College transferring from:
------- Please select an option ------- American River College Butte College Cerro Coso Community College Consumnes River College Folsom Lake College Merced Community College Merritt College North Harris Community College - Lone Star Oxnard College Riverside Community College Sacramento City College San Joaquin Delta College Sierra College Solano Community College
3. Your employment status while in school:
Full Time (30-40 hrs. per week) Part Time (20-29 hrs.) Part Time (1-19 hrs.) Not employed
4. What EOPS services have you utilized? (Mark all that you have used)
Counseling Services Tutorial Services Career Assessment Workshop for major decision making Workshop for career exploration process Workshop on internships and experiential training Computer Lab & Printer Access
5. How useful were the services? (Mark all that you have used)
Very Helpful Helpful Not Helpful Don't Know Counseling Services Tutorial Services Career Assessment Workshop for major decision making Workshop for career exploration process Workshop on internships and experiential training Computer Lab & Printer Access
6. Type of Counseling Used:
Please indicate all that apply: Academic Personal Career or Major Advising Financial Aid