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Black Student Success at Santa Rosa Junior College
Name
First
Last
Email
Phone Number
Are you a high school student ?
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No
Select Your High School
Analy High
Casa Granted High
El Molino High
Elsie Allen High
Maria Carrillo
Montgomery High
Petaluma High
Piner High
Rancho
Ridgway
Santa Rosa
Windsor
Other…
Enter other…
If your high school is not listed, please enter it in this box
Describe your role
High School Counselor
Parent
Community member
Other…
Please describe your role
Have you filled out and completed the SRJC Application?
Yes
No
Would you like help from an UMOJA staff member to complete the application?
Yes
No
Enter your student identification number (SID)
If you finished your SRJC application, you should have recieved an email with your SID.
Please select a session day and time below
Monday April 26th | 4-5pm
Tuesday April 27th | 3-4pm
Wednesday April 28th |3-4pm
Wednesday April 28th | 4-5pm
Thursday April 29th | 3-4pm
Friday April 30th | 12-1pm
Friday April 30th | 1-2pm
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