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Please complete and submit the following form. An academic advisor from Southwest Ohio Educational Opportunity Center will contact you.

Registration Form(The following information will be used to determine eligibility for services from SOEOC.)

Last Name
First Name
Middle Initial
Address
City
State
Zip Code
County
Telephone
E-mail Address

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Sex FemaleMale

Age 14-1819-2728+

Ethnic Background American IndianAsianAfrican AmericanHispanicPacific IslanderWhite

Are you a U.S. Citizen? YesNoPermanent Resident

Is English your native language? YesNo

Do you have a disability? YesNo

Are you a veteran? YesNo

Did either of your parents receive a four-year degree? MotherFatherBothNeither

What type of school are you interested in attending? Vocational / Technical School2-Year College4-Year College

When do you plan to start school? FallWinterSpringSummer

What do you need in order to begin or continue your postsecondary education? Financial Aid HelpAdmissions HelpCareer Search HelpAdmission Test HelpEducation Support: Academic Advising, Study Skills Instruction, Postsecondary Orientation, Mentoring, Tutoring

How did you find the Southwest Ohio Educational Opportunity Center website?

By submitting this form, I certify that to the best of my knowledge all the information provided here is current and accurate. I grant SOEOC permission to provide advising services and maintain a confidential file. I authorize the use of this information for reporting and I understand my identity will not be revealed.