GtC Application | Gateway to College

Please complete and submit this form and we will respond via e-mail within 3 working days.

Fields with the red * are required.

Eligibility Rules

Applicants must meet the following eligibility requirements, per the GtC Academy charter authorized through LEA Petaluma City Schools:

16-20 years old
Resident of the state of California

SRJC Student ID Number (if you have one)

Last Name

First Name

Your preferred Gender Identity Pronoun (e.g. She/He/Ze/They/Other)

Date of Birth

How old will you be on January 6, 2020?

Phone number (XXX) XXX-XXX

E-mail Address

Current Street Address

Apt. Number

City

State

Zip

Caregiver (parent/guardian) Name(s) *required if applicant is under 18 years old

Preferred Language of Caregiver(s)

Their relationship to you

Phone number(s) (required if applicant is under 18 years old)

Caregiver/Guardian E-mail(s) (required if applicant is under 18 years old)

Your current/last high school attended

If selected for the Gateway to College Academy (GtC), I agree to abide by the Santa Rosa Junior College (SRJC) Code of Student Conduct, the Petaluma City Schools policies, as well as the policies and procedures of the Gateway to College program.

I also understand that I will be required to attend classes Monday through Friday typically during the times listed below:

Monday-Thursday: 9:00AM-3:00PM; Friday: 9:00AM-2:00PM

If accepted, I understand that all students must attend required classes five days per week, Monday-Friday, including both high school and college courses.

Please print your name if you agree to the terms and conditions written above:

Click here to download the mandatory Enrollment Packet. (link opens in a new window. You must return to this form to submit it)

(if you need assistance completing this packet, please contact Kathleen at kmendozamontano@santarosa.edu)