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Portland Community College

 

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Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Information Please tell us when you might be attending Portland Community College.

Entry Term
Term of Entry:Required

Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Information Please use proper upper and lowercase letters to ensure proper mail delivery.

Primary Address
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:Required
ZIP or Postal Code:Required
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Birthdate
Date of Birth:Required Month Day Year (YYYY)

Information Please provide an email.

E-Mail Address
E-mail Address:
Verify E-mail Address:

Ethnicity/Race

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
American Indian/Alaska Native
Asian
Black or African American
Native Hawaiian/Pacific Island
White

Information Please tell us what you might be interested in studying.

Major
Major:Required

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Release: 8.5.4