OCC Pride Scholar Interest Form

Student ID Number

Email Address

Preferred Name

Legal Name (for our records)

Last Name

Pronouns

Phone Number

Is it okay to text you about LGBTQIA+ news and events?

Yes

No

What code should we use in place of "LGBTQIA?"

We always have lunch at Pride Scholars, so please list any dietary restrictions you may have!

Do you need textbook assistance?

Yes

No

Are you part of EOPS, Student Equity, Pirate's Promise, Umoja, or Guardian Scholars?

Yes

No

Are you a California College Promise Grant Recipient (CCPG = Tuition fee waiver)?

Yes

No

Unfortunately, we are not able to offer additional assistance to students who are in programs that already provide textbook assistance. If you need further support, please talk to the corresponding program specialist.

Please fill out the Basic Needs Textbook Assistance Form!

Unfortunately, we do not currently have resources for textbook assistance for students who are not CCPG eligible, but we are working on it!

What kind of programming & events are interested in seeing or hosting on campus?

What topics of discussion are you interested in for Pride Scholars meetings? They don't have to be specifically LGBTQIA+ related!

Are you interested in participating in our Pirate Bucks pilot program, in which we would load $150 onto your student account/ID for you to use at any of our college dining locations (including Starbucks!) or on GrubHub? (Must sign up by March 1st, 2024)

Yes

No

Awesome! Keep any eye out for an email on how to use your account.