MESA Applicaton MESA Application 1. First Name* 2. Last Name* 3. Preferred Pronouns* She/Hers He/His They/Them/Theirs 4. Preferred Email* 5. Major* 6. Are you a current Clark College student?* Yes No 7. Are you a Running Start student?* Yes No 8. Do you plan to transfer to a 4-year university/institution?* Yes No Undecided HiddenEthnicity:American Indian or Native AlaskanBlack/African AmericanLatinx/HispanicPacific Islander/Native HawaiianAsianWhiteOtherIf Multi-racial, please select all those that apply9. Ethnicity:* American Indian or Native Alaskan Black/African American Latinx/Hispanic Pacific Islander/Native Hawaiian Asian White Other If Multi-racial, please select all those that applyOther Ethnicity 10. What are obstacles that may interfere with your education? Please check all that apply. Financial need Employment issues Family obligations Knowledge of educational system Transportation/travel distance Exceptional needs (specify below) Prefer not to answer Exceptional Needs11. Projected Graduation Date from Clark MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.