Online Counseling Intake Form

First Name: Last Name

Student Number Beginning with 000 :   

Phone Number (optional):
 

Email Address: (required)
 

Confirm Email Address: (required)
 

Are you currently an enrolled Rio Hondo College student:
yes
no

Are you enrolled in an online course (Virtual College)?
yes
no

Have you attended other colleges/universities?
yes
no
If you answered 'yes', are your transcripts on file with the Admissions & Records office?
yes
no

What is your major?

Educational Objective:
Certificate
AA/AS Degree
BA/BS Degree
Other (please specify ):

What is your career goal?

Please submit your question to an online counselor:
(click on the "submit" button below when you are through)

NOTE: the above form is not a secure internet website.