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Application for EOPS
Extended Opportunity Programs & Services
                                                        San Diego Mesa College website : www. sdmesa.edu
                  Student Web Services of San Diego Community College District: http://studentweb.sdccd .edu
                                                                          Tel # (619) 388-2706, Fax # (619) 388-2464
                                           7250 Mesa College Drive, Building I-300, Room 101, San Diego, CA. 92111
All applicants must also apply and be determined eligible for a Board of Governors Fee Waiver (BOGW) and be enrolled in
12-units or more at San Diego Mesa College for your application to be processed for EOPS admission.


Last Name                                   First                  Middle Initial      CSID #


Address Street                                              Apt#                         City                          State       Zip


Email Address                               Home Phone                                   Cell #:
1. Number of units you will take: Fall:                                              Spring:
2. List Colleges/Universities you have attended. Attach extra sheets if needed. Official transcripts from all colleges
   attended required, please send to: San Diego Community College District Records Office.
   Unofficial copies are accepted temporarily with this application.
            College                    Dates Attended                 Units Completed                Were you an EOPS student?




3.   Gender: Male       Female        4. Age: Under 18      ; 18-25   ; 26-35        ; 36-45       ; 46-55      ; 56-65        ;   65+
5.   Marital Status:                                       6. Ages of Dependent Children:
7.   Income you receive:    Employment              SSI/GR/GA      TANF/CalWORK                 Other
8.   Are you a California resident?                                                                 Yes             No
9.   Have you applied for Board of Governors Fee Waiver (BOGW)? (Required)                          Yes             No
10. Have you filed a Free Application for Federal Student Aid (FAFSA)                               Yes             No
11. Have you taken the assessment tests at Mesa College?                                            Yes             No
     If not, contact the Assessment Testing Office in room I-420, Tel. # (619) 388-2718 for an appointment. Assessments
     must be taken as soon as possible to be considered for admission.
12. Have you received a high school diploma: Yes/Graduate          ; GED    ;   No        In progress at
13. What was your high school GPA?
14. Have you ever enrolled in a remedial class or course? If so, name course(s):
    (Provide prior college transcripts verifying courses). (If within SDCCD; ESOL, ENG.42, 43, 50, 55, MATH 32-35)
15. Did either of your parents graduate from a four-year college or university?                      Yes           No
16. Please state your ethnic background:
17. What is your primary language spoken at home?
18. Are you or have you ever been an emancipated Foster Youth? Yes              No      If so, what time period
                                               * please continue on other side *
                                                                                                        EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
EDUCATIONAL GOAL SURVEY

Please answer the questions below to help us determine your counseling needs.

1. My educational goal at San Diego Mesa College is to achieve (check all that apply):
       Certificate of Completion               Associate Degree             Undecided     Transfer to a University (check
    one):
                      University of California (UC) Campus:
                      California State University (CSU) Campus:
                      Private College/Institution:
                      Other:
                      Undecided

2. My college major is:
3. I am undecided about my major, however, I am interested in:


4. How did you find out about EOPS?



                                  Application for the CARE Program for Single Parents
                                      Cooperative Agencies Resources for Education

For single parents with children under 14 years old, CARE is a supplemental program of EOPS and provides added
educational support services designed for the academically under-prepared, low income, single parent population.
Grants for educationally related expenses may be awarded as a means of strengthening the retention, persistence,
and graduation and transfer rates of students.
Have you previously participated in CARE Program?                     Yes        No
If yes, provide semester, year and Institution where services were received:

Marital Status:
Are you a single head of household?                                   Yes        No
Are you receiving TANF or CalWorks benefits now?                      Yes        No     When
Do you have one child under the age of 14?                            Yes        No

To be eligible for grant money from EOPS and CARE, you must have a Free Application For Federal Student Aid (FAFSA),
on file at SD Mesa College. Apply on-line at www.fafsa.ed.gov , for fastest processing.
As an option, you may obtain the application at the Financial Aid Office, I-300, Telephone (619) 388-2817.

I am aware that the information that I have provided will be used to determine my eligibility for EOPS and CARE.
I certify under penalty of perjury that this information is true, complete, and accurate to the best of my knowledge.


Student Signature                                                                       Date

                                                                                                   EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
SAN DIEGO MESA COLLEGE
                              Extended Opportunity Programs and Services
                              MUTUAL RESPONSIBILITY CONTRACT (MRC)
                                   www.sdmesa.edu Click Student Services. Click EOPS

Print Name:                                                    CSID Number:
                   Last           First                MI

Welcome to EOPS. We help students to succeed and obtain goals by providing consistent guidance, academic,
career and personal counseling. This mutual agreement outlines services provided and requirements for students to
stay in “good standing’ with EOPS in order to continue to receive services.
                          SERVICES:                                 As an EOPS Student, each semester I will:
   s      Priority registration                                         x Submit a completed Progress Report by
   s      Book vouchers, (pending funds)                                  the deadline date indicated for the term.
   s      Financial grants, depending on available funds                x Complete 3 Counseling Contacts and
          Emergency Loans
                                                                          Complete 1 Workshop by deadline set
   s
                                                                        x
   s      Application fee waivers to UC’s & CSU’s
          Individual Student Educational Plan
                                                                        x Contacts are defined as:
                                                                              (A) Orientation, Assessment &
   s

   s      EOPS/CARE Leadership club and support group
                                                                                  Ed Plan Counseling Session
   s      Student Success Workshops
                                                                              (B) Long Term Planning &
   s      Individualized tutoring through STAR
                                                                                  Retention Counseling Session
   s      CARE for single parents on Cal-WORKS
                                                                              (C) Counseling Exit Session
   s      Personal, academic and career counseling
                                                                              (D) 1 Workshop from the workshop
   s      Referrals to campus and community services
                                                                                  list provided by EOPS
   s      Nominations to EOP programs at CSU’s
   s      Scholarship assistance                                           *All contacts require appointments *

                STUDENT REQUIREMENTS:                                    x   I must comply with all of the items listed
   x      It is my responsibility to comply & understand                     under “Student Requirements” to be in
          the following program regulations: I will …                        good standing and eligible for EOPS
   x      Meet with an EOPS counselor to develop & update                    services and grants.
          a Student Educational Plan & enroll in at least 12
                                                                         x   Non-compliance with the items listed
          units per semester, of which 9 must be at Mesa in
                                                                             under “Student Requirements,” may
          order to receive program support services. All
                                                                             cause all EOPS grants, & services to be
          courses must be from my Educational Plan.
   x      Complete a petition, if under 12 units, with my                    withdrawn.
          EOPS counselor & see an EOPS counselor for any                 x   The grant is available to students with an
          revisions, drops or updates to my classes before                   unmet financial need.
          changes are made.                                              x   I understand that I have the right to
   x      Be ineligible for an EOPS grant, if I drop below                   petition for reinstatement.
          9 units of Mesa College courses, drop below a
          2.0 GPA , exceed 6 semesters of services and/or
                                                                         x   I authorize release of information and
          a total of 70 units completed within the semester.                 records to other colleges, programs, or
   x      Participate in Academic Intervention as required                   agencies that have a vested interest in my
          by my counselor.                                                   program compliance, recommendations
   x      Inform the Admissions and EOPS Office when                         and requirements.
                                                                    Note: Students are encouraged to obtain an email
          changes of address, e-mail & telephone occur.             account and visit the Mesa College, EOPS web site
   x      Adhere to all requirements for grants and books.          above for program information.

Fall                                                                Spring
       Student Signature                    Date                              Student Signature                          Date



Counselor Initials: Fall______ Date______                           Counselor Initials: Spring______ Date______
                                                                                                  EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
What is EOPS?
Extended Opportunity Programs and Services
                            Web address : sdmesa.edu , → click Student Services , → click EOPS.
        Student Web Services of San Diego Community College District: http://studentweb.sdccd.edu
                                                      Tel # (619) 388-2706, Fax # (619) 388-2464
                        7250 Mesa College Drive, Building I-300, Room 101, San Diego, CA. 92111

                                                     Hours: Monday to Friday, 8:00 a.m. to 5:00 p.m.

EOPS is a state funded student service program designed to provide recruitment, retention, and
transition services to students with educational and economic challenges.

Who Is Eligible?
Students may be eligible for the program if they meet all of the following criteria:
   1. Must be a California resident, as determined by the College Admissions Office
   2. Must be enrolled in 12 units or more, with a minimum of 9 units at Mesa College
   3. Qualified to receive the Board of Governors Waiver A or B
   4. Meet the Board Of Governors Waiver (BOGW) Income Guidelines
   5. Apply for the Free Application for Federal Student Aid (FAFSA)
   6. Have not completed more than 70-degree applicable college courses
Additionally, students must meet one of the following criteria:
    q   Scored at or below the minimum level placement test scores needed to enroll in an English
        or Math class necessary for an Associate Degree.
    q   Not a high school graduate or GED recipient
    q   If graduated from high school, overall gpa was 2.49 or below
    q   Previously enrolled in remedial courses (Eg.:ESOL, ENGL.42,43,50,55, MATH 32-35)

How do I apply for EOPS? Complete the following applications:
   1.   EOPS application
   2.   Board of Governors Fee Waiver (BOGW), go to the Financial Aid Office, I-300
   3.   Free Application for Federal Student Aid (FAFSA), ), go on-line at www.fafsa.ed.gov
   4.   Submit all prior college transcripts to San Diego Community College Records office.

All of the above applications are accepted throughout the academic year
What Services does EOPS offer?
   q  Academic, personal, and career                        q     University transfer assistance &
      counseling                                                  application fee waivers
   q  Priority enrollment for classes                       q     Academic & personal success
   q  STAR Tutoring individual assistance                         workshops
   q  EOPS cash grants                                      q     Financial aid application assistance
   q  Book vouchers                                         q     CARE program, assistance for single
   q  EOPS scholarship                                            parents
   q  Scholarship application assistance                    q     EOPS & CARE student club &
   q  Emergency loans                                             leadership opportunities
What types of helpful services are provided to students?
      q   Comprehensive student program orientation and educational planning
      q   One-on-One academic, career and personal counseling
      q   Personal, Career & Academic success workshops
      q   Motivational sessions with counselors help students improve their academic performance
      q   Free tutoring through the STAR Tutorial program helps students learn difficult material in their classes,
          and to succeed in College
      q   Required communication and feedback from instructors through a Progress Report helps students
          determine strategies to improve their course performance


Do You Give Books?
You must attend an orientation and complete the Book Voucher Contract in order to have your eligibility for books
determined. You must be an EOPS student in good standing in order to apply for a book voucher.
Due to the limited amount of money available, book vouchers are on a first-come, first-served basis.


If I qualify, do I get a grant immediately?
Grants are usually disbursed at the end of the semester
EOPS provides grants to eligible students who meet the program criteria/requirements stated in the Mutual
Responsibility Contract and have an unmet financial need, as determined by the Financial Aid Office.


What is required of EOPS students accepted into the program?
Every Fall & Spring semester, eligible students must complete the following:

          Must attend a student orientation
          Must meet with an EOPS Counselor a minimum of twice a semester
          Must attend an academic workshop
          Must maintain a 2.0 GPA or higher
          Must complete a student educational plan and Long Term Plan
          Must enroll in 12 units or more every semester (minimum of 9 units at Mesa)




EOPS NEW STUDENT APPDOCS0809.doc
                                                            2

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Soroptimist Disaster Recovery Grants for Women and Girls

  • 1. Print Form Application for EOPS Extended Opportunity Programs & Services San Diego Mesa College website : www. sdmesa.edu Student Web Services of San Diego Community College District: http://studentweb.sdccd .edu Tel # (619) 388-2706, Fax # (619) 388-2464 7250 Mesa College Drive, Building I-300, Room 101, San Diego, CA. 92111 All applicants must also apply and be determined eligible for a Board of Governors Fee Waiver (BOGW) and be enrolled in 12-units or more at San Diego Mesa College for your application to be processed for EOPS admission. Last Name First Middle Initial CSID # Address Street Apt# City State Zip Email Address Home Phone Cell #: 1. Number of units you will take: Fall: Spring: 2. List Colleges/Universities you have attended. Attach extra sheets if needed. Official transcripts from all colleges attended required, please send to: San Diego Community College District Records Office. Unofficial copies are accepted temporarily with this application. College Dates Attended Units Completed Were you an EOPS student? 3. Gender: Male Female 4. Age: Under 18 ; 18-25 ; 26-35 ; 36-45 ; 46-55 ; 56-65 ; 65+ 5. Marital Status: 6. Ages of Dependent Children: 7. Income you receive: Employment SSI/GR/GA TANF/CalWORK Other 8. Are you a California resident? Yes No 9. Have you applied for Board of Governors Fee Waiver (BOGW)? (Required) Yes No 10. Have you filed a Free Application for Federal Student Aid (FAFSA) Yes No 11. Have you taken the assessment tests at Mesa College? Yes No If not, contact the Assessment Testing Office in room I-420, Tel. # (619) 388-2718 for an appointment. Assessments must be taken as soon as possible to be considered for admission. 12. Have you received a high school diploma: Yes/Graduate ; GED ; No In progress at 13. What was your high school GPA? 14. Have you ever enrolled in a remedial class or course? If so, name course(s): (Provide prior college transcripts verifying courses). (If within SDCCD; ESOL, ENG.42, 43, 50, 55, MATH 32-35) 15. Did either of your parents graduate from a four-year college or university? Yes No 16. Please state your ethnic background: 17. What is your primary language spoken at home? 18. Are you or have you ever been an emancipated Foster Youth? Yes No If so, what time period * please continue on other side * EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
  • 2. EDUCATIONAL GOAL SURVEY Please answer the questions below to help us determine your counseling needs. 1. My educational goal at San Diego Mesa College is to achieve (check all that apply): Certificate of Completion Associate Degree Undecided Transfer to a University (check one): University of California (UC) Campus: California State University (CSU) Campus: Private College/Institution: Other: Undecided 2. My college major is: 3. I am undecided about my major, however, I am interested in: 4. How did you find out about EOPS? Application for the CARE Program for Single Parents Cooperative Agencies Resources for Education For single parents with children under 14 years old, CARE is a supplemental program of EOPS and provides added educational support services designed for the academically under-prepared, low income, single parent population. Grants for educationally related expenses may be awarded as a means of strengthening the retention, persistence, and graduation and transfer rates of students. Have you previously participated in CARE Program? Yes No If yes, provide semester, year and Institution where services were received: Marital Status: Are you a single head of household? Yes No Are you receiving TANF or CalWorks benefits now? Yes No When Do you have one child under the age of 14? Yes No To be eligible for grant money from EOPS and CARE, you must have a Free Application For Federal Student Aid (FAFSA), on file at SD Mesa College. Apply on-line at www.fafsa.ed.gov , for fastest processing. As an option, you may obtain the application at the Financial Aid Office, I-300, Telephone (619) 388-2817. I am aware that the information that I have provided will be used to determine my eligibility for EOPS and CARE. I certify under penalty of perjury that this information is true, complete, and accurate to the best of my knowledge. Student Signature Date EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
  • 3. SAN DIEGO MESA COLLEGE Extended Opportunity Programs and Services MUTUAL RESPONSIBILITY CONTRACT (MRC) www.sdmesa.edu Click Student Services. Click EOPS Print Name: CSID Number: Last First MI Welcome to EOPS. We help students to succeed and obtain goals by providing consistent guidance, academic, career and personal counseling. This mutual agreement outlines services provided and requirements for students to stay in “good standing’ with EOPS in order to continue to receive services. SERVICES: As an EOPS Student, each semester I will: s Priority registration x Submit a completed Progress Report by s Book vouchers, (pending funds) the deadline date indicated for the term. s Financial grants, depending on available funds x Complete 3 Counseling Contacts and Emergency Loans Complete 1 Workshop by deadline set s x s Application fee waivers to UC’s & CSU’s Individual Student Educational Plan x Contacts are defined as: (A) Orientation, Assessment & s s EOPS/CARE Leadership club and support group Ed Plan Counseling Session s Student Success Workshops (B) Long Term Planning & s Individualized tutoring through STAR Retention Counseling Session s CARE for single parents on Cal-WORKS (C) Counseling Exit Session s Personal, academic and career counseling (D) 1 Workshop from the workshop s Referrals to campus and community services list provided by EOPS s Nominations to EOP programs at CSU’s s Scholarship assistance *All contacts require appointments * STUDENT REQUIREMENTS: x I must comply with all of the items listed x It is my responsibility to comply & understand under “Student Requirements” to be in the following program regulations: I will … good standing and eligible for EOPS x Meet with an EOPS counselor to develop & update services and grants. a Student Educational Plan & enroll in at least 12 x Non-compliance with the items listed units per semester, of which 9 must be at Mesa in under “Student Requirements,” may order to receive program support services. All cause all EOPS grants, & services to be courses must be from my Educational Plan. x Complete a petition, if under 12 units, with my withdrawn. EOPS counselor & see an EOPS counselor for any x The grant is available to students with an revisions, drops or updates to my classes before unmet financial need. changes are made. x I understand that I have the right to x Be ineligible for an EOPS grant, if I drop below petition for reinstatement. 9 units of Mesa College courses, drop below a 2.0 GPA , exceed 6 semesters of services and/or x I authorize release of information and a total of 70 units completed within the semester. records to other colleges, programs, or x Participate in Academic Intervention as required agencies that have a vested interest in my by my counselor. program compliance, recommendations x Inform the Admissions and EOPS Office when and requirements. Note: Students are encouraged to obtain an email changes of address, e-mail & telephone occur. account and visit the Mesa College, EOPS web site x Adhere to all requirements for grants and books. above for program information. Fall Spring Student Signature Date Student Signature Date Counselor Initials: Fall______ Date______ Counselor Initials: Spring______ Date______ EOPS/FORMS/EOPS NEWSTU APPDOC0809) LN.
  • 4. What is EOPS? Extended Opportunity Programs and Services Web address : sdmesa.edu , → click Student Services , → click EOPS. Student Web Services of San Diego Community College District: http://studentweb.sdccd.edu Tel # (619) 388-2706, Fax # (619) 388-2464 7250 Mesa College Drive, Building I-300, Room 101, San Diego, CA. 92111 Hours: Monday to Friday, 8:00 a.m. to 5:00 p.m. EOPS is a state funded student service program designed to provide recruitment, retention, and transition services to students with educational and economic challenges. Who Is Eligible? Students may be eligible for the program if they meet all of the following criteria: 1. Must be a California resident, as determined by the College Admissions Office 2. Must be enrolled in 12 units or more, with a minimum of 9 units at Mesa College 3. Qualified to receive the Board of Governors Waiver A or B 4. Meet the Board Of Governors Waiver (BOGW) Income Guidelines 5. Apply for the Free Application for Federal Student Aid (FAFSA) 6. Have not completed more than 70-degree applicable college courses Additionally, students must meet one of the following criteria: q Scored at or below the minimum level placement test scores needed to enroll in an English or Math class necessary for an Associate Degree. q Not a high school graduate or GED recipient q If graduated from high school, overall gpa was 2.49 or below q Previously enrolled in remedial courses (Eg.:ESOL, ENGL.42,43,50,55, MATH 32-35) How do I apply for EOPS? Complete the following applications: 1. EOPS application 2. Board of Governors Fee Waiver (BOGW), go to the Financial Aid Office, I-300 3. Free Application for Federal Student Aid (FAFSA), ), go on-line at www.fafsa.ed.gov 4. Submit all prior college transcripts to San Diego Community College Records office. All of the above applications are accepted throughout the academic year What Services does EOPS offer? q Academic, personal, and career q University transfer assistance & counseling application fee waivers q Priority enrollment for classes q Academic & personal success q STAR Tutoring individual assistance workshops q EOPS cash grants q Financial aid application assistance q Book vouchers q CARE program, assistance for single q EOPS scholarship parents q Scholarship application assistance q EOPS & CARE student club & q Emergency loans leadership opportunities
  • 5. What types of helpful services are provided to students? q Comprehensive student program orientation and educational planning q One-on-One academic, career and personal counseling q Personal, Career & Academic success workshops q Motivational sessions with counselors help students improve their academic performance q Free tutoring through the STAR Tutorial program helps students learn difficult material in their classes, and to succeed in College q Required communication and feedback from instructors through a Progress Report helps students determine strategies to improve their course performance Do You Give Books? You must attend an orientation and complete the Book Voucher Contract in order to have your eligibility for books determined. You must be an EOPS student in good standing in order to apply for a book voucher. Due to the limited amount of money available, book vouchers are on a first-come, first-served basis. If I qualify, do I get a grant immediately? Grants are usually disbursed at the end of the semester EOPS provides grants to eligible students who meet the program criteria/requirements stated in the Mutual Responsibility Contract and have an unmet financial need, as determined by the Financial Aid Office. What is required of EOPS students accepted into the program? Every Fall & Spring semester, eligible students must complete the following: Must attend a student orientation Must meet with an EOPS Counselor a minimum of twice a semester Must attend an academic workshop Must maintain a 2.0 GPA or higher Must complete a student educational plan and Long Term Plan Must enroll in 12 units or more every semester (minimum of 9 units at Mesa) EOPS NEW STUDENT APPDOCS0809.doc 2