College of Extended & International Education - OSHA Training Institute

Request for Free a Catalogue

In order to better serve your educational needs, we would like to ask you a few questions. Please fill out the form below. If you have already filled out the form, then simply enter your basic information, including your student ID number, and hit submit.

Which catalogue would you like?
Spring Summer Fall Open University
Programs In Which You Are Interested:  

Personal Information
Name (First & Last): * *
Address Line 1: *
Address Line 2 (if needed):
City / State, ZIP: / * , *
Phone:
E-Mail: *
Employer
Job Title
Work Zip Code:
Birthdate
If current or former CSUDH Student, Enter Student ID Number

* Required Fields

If you have already filled out your educational needs submit form here. Otherwise, please continue below.

Educational Needs Survey
Age
Marital Status
Married Single
Gender
Male Female
What level of schooling have you completed?
HS Graduate Some College AA/AS Degree
BA/BS Degree Masters Degree Doctorate
Why are you interested in Extended Education courses?
Career Change Enter the Workforce General Interest
Personal Growth Professional Growth/
Job Promotion		 Required for Job
What is your employment status?
Full Time Part time Unemployed
Full time student Part time student Retired
In what business or industry do you work?
What type of job do you have?
Professional Sales Managerial
Self-employed Technical Clerical
Administrative Other
How did you learn about this program?

Search Engine
Name

E-mail

Another Web Site
Name

EE Catalog Employer Word of Mouth
Education Fair or
Job Fair		 Current CSUDH Student Brochure/Flyer
Television Radio Newspaper/Magazine
  Other

 
It would be most convenient for me to take classes:
On CSUDH Campus Via the Internet At my job
It would be most convenient for me to attend courses at the following time:
Weekday Mornings Weekday Afternoons Weekday Evenings (after 6pm)
Weekends Via the Internet  
What time of year would you most like to take classes?
Fall (Sept-Nov) Winter (Jan-Feb) Spring (March-May)
  Summer
(June-Aug) 		 
What time of year would you least like to take classes?
Fall (Sept-Nov) Winter (Jan-Feb) Spring (March-May)
  Summer
(June-Aug) 		 
Combined family income per year