For assistance or more information, please contact: Elizabeth Billy Program Coordinator, Native American Summer Bridge Office of Student Equity 384 Pioneer Hall Santa Rosa Junior College (707) 527-4609 ebilly@santarosa.edu Please take a moment to complete this five minute application. You may contact the Native American office at nasb@santarosa.edu or 707-527-4609 with any questions. We look forward to seeing you this summer! First Name * Last Name * Mailing Address City State Zipcode Date of Birth Gender Male Female Non-Binary Prefer not to disclose Home Phone * Cell Phone Email * What is your enrollment status at high school? * Sophomore Junior Senior What is your age? Parent/Guardian #1 Name * Parent/Guardian #1 Email * Parent/Guardian #2 Name Parent/Guardian #2 Email Next
