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CSUN Explorers Application


Please complete the application to the best of your ability. If you have any questions please contact Amy Hanreddy at amy.n.hanreddy@csun.edu. We look forward to receiving your application.
First and Last Name
Required
Home Address
Required
Phone Numbers
Required
Email Address
Required
Who do you live with?
Do you have a conservator/guardian who should be involved in decisions about your education?  If so, please list that person's name and contact information here:
Required

Demographics

What is your age?
Required
What languages do you speak?
Required
How do you identify yourself?
Required
Which of the following best describes you?

Education and Services

High School (please provide name)
Required
What year did you complete, or anticipate completing high school?
Required
Did you obtain a
Required
You don't need strong academic skills to be an Explorer, but the information below will help us to understand your strengths and support needs.
Which best describes your reading skills?
Which best describes your skills when understanding text and stories?
Which best describes your writing skills?
Which best describes your math skills?
Please list and describe accommodations used in school.
Required
Have you participated in any college or other program since finishing high school?
Required

Work/Volunteer Experience

Work or volunteer experience is not required to be an Explorer.  The information below will help us understand your background.
Name of Business/Organization #1
Duties of Experience #1
Required
Hours per week at Experience #1
Required
How long were you at Experience #1?
Required
Name of Business/Organization #2
Required
Duties of Experience #2
Required
Hours per week at Experience #2
Required
How long were you at Experience #2?
Required
Name of Business/Organization #3
Required
Duties of Experience #3
Required
Hours per week at Experience #3
Required
How long were you at Experience #3?
Required
Were you paid for any of the jobs listed above?
Required
Have you ever been terminated from a paid or volunteer experience?
Required

Hobbies and Favorite Activities

List and describe what you like to do in your free time.
Required
What is your favorite activity to participate in? (List as many as you wish)
Do you like music?  What type and do you play any instruments?
Do you have any other special skills or abilities?
Required
Do you spend time with friends outside of school?
Required

Needs and Styles


Help us get to know your needs so we can get to know you better. Please rate yourself in the following areas-with 1 being "I can do this on my own, independently" and 5 being "I need lots of support".
Required
1 (I can do this independently)

 

2

 

3

 

4

 

5 (I need lots of support)

 

Reading
Required
Writing
Required
Typing on a tablet, laptop, or computer
Required
Taking notes for school work
Required
Finishing Homework
Required
Following a Schedule
Required
Purchasing Meals
Required
Navigating Around the Campus
Required
Using Public Transportation
Required
Problem Solving
Required
Why do you want to become a CSUN Explorer?
Required
What types of jobs/careers are you most interested in?
What academic subjects interest you?
Required
Which social activities would you be most interested in as a CSUN student?