Project Preliminary Application

Mohawk Valley Community College’s Educational Opportunity Center is designed to help area residents further their education by completing secondary school and entering college. Completing this pre-enrollment survey will help MVCC/EOC staff select those who can benefit from the project.

Name: (Last, First, Middle Initial):     Last , First M.I.
Home E-Mail:

Home Address
City     State Zip
Daytime Phone: Cell Phone:
Date of Birth: / /

Currently Employed : Yes No
Most Recent (or current) Place of Employment: 
Job Title 
Dates of Employment: 
Other Work History 

Please help us by assessing your level of knowledge in these areas. Please check all that apply.

  Tutoring (writing)   Tutoring (math)   Tutoring (science)
  Tutoring (reading)   Tutoring (history)
  Career Planning
  Financial Aid Assistance
  College Search

  No High School Diploma or GED   Interested in obtaining GED
  Earned GED   High School Graduate
  2-Year College Graduate   4-Year College Graduate
  Trade/Vocational School   Attended College (did not complete)

Please list any additional education information or certifications that you hold. 

Equal Opportunity Employer/Program. Auxiliary aids and services are available upon request to individuals with disabilities.
EOC is funded with a federal TRiO Grant from the U.S. Department of Education

Questions? Contact EOC Project Staff at (315) 507-2776