Counseling Center, Fullerton College

INTAKE FORM for on-line counseling at Fullerton College. This information is required in order to process your request for counseling assistance from a qualified FC counselor. Please note if required information is missing, your request will not be transmitted.

First Name:
Last Name:
Student ID #:
Email:
Are you currently enrolled at FC?	Yes: No:
Have you attended any other colleges or universities?	Yes: No:
What is your major or career goal?
What is your educational goal/objective?	Vocational certificate AA/AS Degree BA/BS Degree Other (please specify)
Please use this box to submit your question: Click on the submit button when completed.

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North Orange County Community College District
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