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Pre-Collegiate Online Application
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Pre-Collegiate Program Application
If you, as a student have a physical or mental impairment that requires testing accommodations, you must schedule an intake interview with the campus counselor for students with disabilities. For additional information, please contact the
Student Access Center
at the campus you plan to attend.
First Name:
Middle Initial:
Last Name:
Gender:
Date of Birth:
Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Graduation Date (month, year):
Type of diploma:
High School Diploma
Foreign Diploma
HSE (TASC)
Subject Interest(s):
Math
English
ESL
Campus:
City
South
North
What is your primary language?
Would you like to improve your computer skills?
Yes
No
Would you like assistance with developing a resume?
Yes
No
Information below assists the college in receiving Federal, State and Grant Aid
American Indian or Alaskan Native (maintaining Tribal affiliations)
Asian (Far East, Southeast Asia, India, Pakistan)
Black or African American (including Africa)
Native Hawaiian or Pacific Islander (including Guam, Samoa)
White (including Europe)
Unknown
Non-Hispanic/Non-Latino
Hispanic/Latino-Central American
Hispanic/Latino-Cuban
Hispanic/Latino-Dominican
Hispanic/Latino-Mexican
Hispanic/Latino-Puerto-Rican
Hispanic/Latino-South American
Hispanic/Latino-Other
Are you a U.S. Citizen?
Yes
No
Country of Citizenship:
How did you hear about the Pre-Collegiate Program?
Pre-Collegiate Representative
SUNY Erie Counselor/Contact
High School Counselor
Other
Need Help?
Pathways to Success
City Campus
45 Oak Street, Room 110 and 138 (EAL)
Buffalo, NY 14203
P:
(716) 851-1109
F:
(716) 851-1015
North Campus
Gleasner Bldg, Room 156
6205 Main St.
Williamsville, NY 14221
P:
(716) 851-1423
South Campus
Building 4, Room 4204B
4041 Southwestern Blvd.
Orchard Park, NY 14127
P:
(716) 851-1691