American Ethnic and Gender Studies
Program Application Form
Please fill out the program application form at the beginning of your AEGS studies, if possible. Later, at
the end of your studies (at the start of the quarter you will be completing the certificate,) you will need to
fill out a brief certificate application form and pay $10 to the college cashier in order to receive credit
toward the certificate.
Date:___________________________
First name(s):____________________________ Family Name:__________________________________
Student ID:_________________________________________________________________________________
Permanent mailing address:_______________________________
City:_______________ State:_______
Postal code:___________________________ Phone:_________________________________________
Email:____________________________________
Date you started attending TCC_________________________
Principal subject of study at TCC________________________________________________________
Are you seeking a degree at TCC? Yes/No If so, what is your expected date of graduation? ___________
If you have already taken some AEGS courses, please list them here:
1) _____________________________________________________________
2) _____________________________________________________________
3) _____________________________________________________________
How did you first hear about the program?____________________________________________________
__________________________________________________________________________________
Return completed application to Dr. Andrew Cho, Tacoma Community College, 6501 South 19th Street- F1,
Tacoma, Washington 98466-6100, or send email to ACHOy@tacomacc.edu, or call (253) 566-5355
.
This area for use by coordinator only
Grades in AEGS courses are C or above?
Yes / No
Program completion date: ________________
03/2008 ef
Certificate processed date: _____________________
03/2008 ef