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Bridges Enrollment Form

Cascade JH 218 | Program Coordinator: Shari Rochelle | 971-722-5076

If you meet the eligibility criteria for the Portland Bridges To Baccalaureate Program and would like to enroll, please fill out the enrollment form below for the Portland Bridges to Baccalaureate Program. Enrollment in the program provides access to the Bridges email listserv (pbtb@lists.pcc.edu), invitation to Bridges sponsored events, eligibility to apply for a paid summer research internship at PSU and participation in the Student Association for Biomedical and Behavioral Sciences (SABBS). This is a secure form to ensure the safety of your personal information.

Student Information
Gender:
 Ethnicity: select all that apply
Enrollment Status:
Educational Goal:
Do you plan to transfer to another institution?
Are you currently employed?
 What types of services are you interested in?:

 Career Interests:
Academic Need
Are you taking or do you plan to take any courses in the following categories? Check all that apply.

  On which campus do you plan to take most of your classes?
 Would you like to be added to the PCC Student Bioscience eMail listserv?
 Would you like information on PCC Student Bioscience Associations?
 
Agreement