10,000 Degrees Interest Form

Comments

This form is associated with the College Access Open Access model. The form will be used to have students at the high school (12th graders) "sign" up to receive our services if they did not attend the College Opportunities Summit so we can create a contact in Salesforce.

CVS Auto Suggest Updated Sep 8, 2023

Overview of 10,000 Degrees

10,000 Degrees is a leading college success nonprofit in California committed to helping students from underrepresented backgrounds get to and through college.

Our services do not have a GPA requirement and are free of charge to the students and families we serve.

We have an unwavering belief in all students’ potential to succeed no matter their GPA, race, gender, sexual orientation, documentation status or socioeconomic status.

Contact Information

First Name

Middle Initial

Last Name

Birthdate

Please format the date as MM/DD/YYYY.

Cell Phone

Personal Email

We suggest you enter a personal email.

Email address given to you by your school

Your Zip Code

What high school do/did you attend?

If your school does not appear, please type "Other High School"

Did you type "Other High School" above? (Our list above may not show your school.)

YesNo

What is the name of the "other" high school?

What year will/did you graduate from high school?

Please type a four-digit year.

What is your high school student ID?

This will help us keep track of the support services we provide you!

Bulk Text Message Opt-Out

Check this box if you do NOT want to receive reminders, resources, and general information from 10,000 Degrees. We may still need to contact you individually about your participation in 10,000 Degrees programs. Opt out at any time by texting STOP.

Opt Out