Fall 2018 LBUSD Ethnic Studies Program Registration Form

Congratulations on being selected to take the Ethnic Studies course through California State University Long Beach. By completing the form below, you understand that you are registering for a college credit course. Please be sure to complete the form accurately.

All fields with a red asterisk must be completed to submit the form.

STUDENT NAME, IDENTIFICATION NUMBER & DATE OF BIRTH

First Name

Middle Initial

Last Name

CSULB Student ID # (Returning CSULB Students Only)

DOB (MM/DD/YYYY)

CONTACT INFORMATION

Preferred Phone (xxx-xxx-xxxx)

Phone Type

Email Address

Mailing Address

City

State

Zip Code

Name of high school currently attending

If your high school wasn't listed, please type it below

COURSE REGISTRATION INFORMATION

215 courses: U.S. Diversity and the Ethnic Experience. This course is a survey of four major ethnic groups (Native American, African American, Chicano/Latino American and Asian American) from the earliest periods of Native American history, through migrations to the Americas, into the present conditions of U.S. society
101 course; 155 course: Advanced courses offered to students who have successfully completed a 215 course.
Courses offered on Saturday, 9:00 AM to 12:00 PM.

Class (section/class #) - Instructor - Location

Contact Information