If you are interested in enrolling in the Accelerated Business Degree Program at FCCJ, please complete the information below.  You may submit the form by:

Fax:  904-632-5092, or mail: FCCJ Accelerated College Office, 601 W. State Street, Jacksonville, FL  32202

If you received this by email, you may return it to slynn@fccj.edu.

 

CONTACT INFORMATION

 

Last Name:                                                                            Social Security Number:                  -         -                                                       

                                   

First Name:                                                                            Middle Name:                                                                      

 

Street:                                                                                                                                                                                                                                                                                                                                                                                                     

 

City:                                                                                                  State:                             Zip:                                     

Phone: (         )                 -                                             E-mail:                        @                                           

            Area Code       

 

PROFESSIONAL EXPERIENCE

 

 

From

 To

Company Name

Position

Responsibilities

JOB 1

 

 

     

     

     

     

     

JOB 2

 

 

     

     

     

     

     

JOB 3

     

 

 

     

     

     

     

JOB 4

 

 

     

     

     

     

     

 

EDUCATION

1. List all credits or degrees earned with dates and names of institutions.  Please check NONE if you have never attended college.     NONE

 

Institution Name

Location (City/State)

Dates of Attendance

Credits earned

GPA

     

 

 

     

           

   

 

     

 

 

     

            

   

 

 

 

2. Have you attended FCCJ’s New Student Orientation?                YES                                NO

 

3. List the month and year you last met with an FCCJ academic advisor:      

 

4. Describe how this degree relates to your career goal(s) and why you are interested in the accelerated format.

 

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PROGRAM ADVISOR NOTES

 

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