Admissions Application Request - Main Form

Program Information
Personal Information
Additional Information
Disclosures and Acknowledgements
Academic
Additional Information

is required

is Required

First Name
Middle Name
Last Name
Email Address
Social Security Number
Date of Birth
Gender
Are you Hispanic or Latino?
Select one or more of the following races:

White

Black or African American

Asian

American Indian or Alaska Native

Native Hawaiian or Other Pacific Islander
Citizenship Status
By providing your mobile number, you agree to receive text messages from Downey Adult School. Standard messaging rates may apply. You can opt out at any time by replying STOP to any message you receive. Downey Adult School will not share or sell your phone number with any third parties. For help contact us at (562) 940-6200.

is Required

Home Address
Country
Street 1
Street 2
City
State
Zip Code Zip Code Extension
Province
Postal Code
Alternate Phone Number Alternate Phone Number Area Code Alternate Phone Number Exchange Alternate Phone Number Number Alternate Phone Number Extension Ext:
Cell Phone Cell Phone Area Code Cell Phone Exchange Cell Phone Number Cell Phone Extension Ext:
International Cell Phone International Cell Phone Extension Ext:
Emergency Contact
Educational Information
Current Employer

is Required

Disclosures
-I understand that I can find the Financial Aid webpage at https://www.das.edu/financial-aid/. This website contains all of the most recent and up-to-date information regarding Financial Aid.

-I understand that I can find the Student Catalog (Handbook) at https://www.das.edu/wp-content/uploads/catalog.pdf.

-I understand that I can fin the Consumer Information Disclosures at https://www.das.edu/student-services/.

-I understand that I can find Downey Adult School's Drug and Alcohol Prevention Program Policy at https://www.das.edu/drug-and-alcohol-abuse-prevention-program/.

-I understand that I can find the refund policy at https://www.das.edu/refund-policy/.

-I understand that I can find the Annual Security Report at https://www.das.edu/annual-security-report-crime-stats/.

-I understand that I am required to attend a 1-hour program orientation which includes both program and financial aid information.

-I understand the financial aid process at DAS and I am aware that any and all paperwork required to fully process my application is my responsibility to furnish in a timely manner.

-I understand that the DAS faculty/staff cannot provide to me, or anyone else, any personal-identifying information over the phone. This includes Financial Aid information. I may obtain information by contacting the Financial Aid Department. For further information regarding Family Educational Rights and Privacy Accct (FERPA), please visit: https://www2.ed.gov/policy/gen/guid/fpco/ferpa/index/html.

-I understand that in order to successfuly earn financial aid, I must meet the Satisfactory Academic Progress (SAP) policies. Failure to do so may result in financial aid being negatively affected. I may be placed on academic probation, and/or I may be required to pay back financial aid monies received. For program-specific SAP policies, please visit https://www.das.edu/satisfactory-academic-progress/.

All students and required to maintain satisfactory academic progress to remain eligible for financial aid. Satisfactory progress is computed on a cumulative basis every module, at any given midpoint/payment period, and at the end of the program. Satisfactory Academic Progress is determined using a qualitative component based on cumulative GPA, and a quantitative component, which consists of a pace of progression as well as a maximum time-frame by which a student must complete his or her program. SAP evaluations for financial aid eligibility are conducted at the end of each program.

-I understand that I can only fail one module and that if I have to repeat a module, I have to pay a repeat-module fee (as outlined in my program).

-I understand that DAS allows students to make payments (with zero interest) for most CTE programs. Payments set up by my program's department must be paid regularly by the 15th of each month.

-I understand that I can find the most recent completion rates, placement rates, license examination passage rates at https://www.das.edu/financial-aid/.

-I understand that I can find salary or wage information for all the CTE programs at https://www.das.edu.

By signing below, I understand and agree to the above disclosures. I also understand and am aware of where to locate all of the school's consumer information disclosures.

By signing below, I understand that this is a legally binding contract. My signature below certifies that I have read, understood, and agree to the policies of Downy Adult School, to my rights and responsibilities, and that the institution's cancellation and refund policies have been clearly explained to me.
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Email Address
Emergency Contact Cell Phone Emergency Contact Cell Phone Area Code Emergency Contact Cell Phone Exchange Emergency US Phone Number Emergency Contact Cell Phone Extension Ext:
Emergency Contact Relationship

is Required

Highest Level of Education
High School Graduation Month
High School Graduation Year
Previous College Attended
Program of Interest
Anticipated Starting Semester

is Required

Other Languages Spoken:
Work Experience:
Signature: (Please type your full name)
Today's Date: (mm/dd/yyyy)

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Career and Education Center

12340 Woodruff Ave | Downey, CA 90241 | (562) 940-6200