Online Counseling

Santa Monica College
Online Counseling Intake Form

First Name:
Last Name:
Phone Number:
Email Address:
Mailing Address:
City, State Zip
 
Are you an F-1 Visa Student?   Yes No
Are you an Out-of-State Student?   Yes No
Are you currently enrolled in high school?    Yes No
Have you attended SMC?   Yes No

What is your educational objective? 
 

What is your major?                        
 (If you selected "other" from the list, enter major below)

When will you be attending Santa Monica College? 

   Semester Attending:

   Year Attending:       

What is your question?

Do you wish to submit your SMC admissions application now? Yes  No

  I have read the Online Counseling user agreement.  I understand and agree to its terms.


Please click the submit button to send your request.

Thank you for your inquiry. It will be routed to the appropriate person or department . You will receive a response within 2 working days.

Tell us how useful this service was to you.  Take the SURVEY.