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Queensborough Community College

CUNY/ Math Start Student Application for Summer and Fall 2019


Welcome! The CUNY/ Math Start application form is the first step in the program’s application process. Please answer the questions below to the best of your ability.

Date_submitted

Personal Information

Date of Birth*
Name*
Address*

Program of Interest

Which program are you applying for?*
Are you a current participant in CUNY EDGE?*

Program of Interest - CUNY Start

Program*
Which of the following full-time schedules work BEST for you?*
Which of the following part-time schedules work BEST for you?*

CUNY seeks to create an inclusive learning environment. If you have an IEP, think you might have a disability, or you have barriers to learning, please notify your CUNY Start Coordinator or Advisor as soon as possible. You may be eligible to receive accommodations for your tests or coursework from CUNY’s Student Disability Office.

Program of Interest - Math Start

Program*
Which of the following full-time schedules work BEST for you?*
Which of the following part-time schedules work BEST for you?*

CUNY seeks to create an inclusive learning environment. If you have an IEP, think you might have a disability, or you have barriers to learning, please notify your CUNY Start Coordinator or Advisor as soon as possible. You may be eligible to receive accommodations for your tests or coursework from CUNY’s Student Disability Office.

Program of Interest - Reading and Writing Start

Which of the following full-time schedules work BEST for you?*

CUNY seeks to create an inclusive learning environment. If you have an IEP, think you might have a disability, or you have barriers to learning, please notify your CUNY Start Coordinator or Advisor as soon as possible. You may be eligible to receive accommodations for your tests or coursework from CUNY’s Student Disability Office.

Program of Interest - Math Start (Fall 2019)

Which of the following schedules work BEST for you?*

CUNY seeks to create an inclusive learning environment. If you have an IEP, think you might have a disability, or you have barriers to learning, please notify your CUNY Start Coordinator or Advisor as soon as possible. You may be eligible to receive accommodations for your tests or coursework from CUNY’s Student Disability Office.

Student Background

1. What is the highest grade you completed in school (not including GED/college)? Check one.*
2. Check your diploma or degree:*
3. When did you get your diploma or GED/HSE?
4. How did you learn about CUNY/ Math Start? Please select the first place or the first person who informed you about CUNY/ Math Start:*
Please check the first place or the first person who informed you about CUNY Start
5. Are you presently working?*

Our program is often asked to describe the racial/ethnic backgrounds of our students and participants. In order to respond to these requests, we ask you to answer the following questions:

6a. Do you consider yourself to be Hispanic/Latino?*
6b. In addition, please select one or more of the following racial categories to describe yourself:
7. What is your gender?*
10. Are you the first in your family to attend college?*
11. What is the highest level of education attained by your parent/guardian with the most education?*
12. What is the highest level of education you hope to achieve?*
13. Do you have any children under the age of 18?*
14. Do you have any children/adults dependent on you for financial support (inside or outside of the home)?*
15. Have you applied for financial aid for 2019-2020?*
16. Do you live with your parent(s)/legal guardian?*
17. Do your parents pay more than half of your expenses?*
18. Which of the following best describes your current situation?*

Education and Testing Background

19. Have you attended any other colleges (including other CUNY colleges)?*
When did you first enroll at any college or university?*
Have you earned any college credits?*
20. Are you familiar with CUNY’s ASAP program?*
21. CUNY Start has a special program that provides financial incentives and support to students in foster care. Are you interested in learning more about this program for yourself or for a friend?*

Sign and Submit

Use your mouse or finger to draw your signature above

After you submit your application, you will receive a confirmation email that indicates that your submission was successful. You will also see a filled-in copy of the application as a printable PDF for your records. Feel free to bring this with you when you meet with the CUNY Start office, although it is not required.

Please do not click "Submit Application" button more than once!

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