Contact Us

Humanities Building, Room H-40
Phone: 510-235-7800-ext. 7255 or 4255
Office Hours: M-Th: 8-4:30, 5:30-8:30 F: 8-4:30
Email: counseling@contracosta.cc.ca.us

Online Counseling Intake Form

Student ID# :: *(optional)
Last Name ::
First Name ::
Street Address ::
City ::
State ::
Zip Code ::
Telephone ::
Email Address ::
Create a Password ::
   
Are you currently a Contra Costa College Student? Yes No
If no, have you attended Contra Costa College in the past? Yes No
If yes, are you currently participating in:
(check all that apply)		 EOPS CSE
DSPS Athletics
Puente CalWORKs
PACE Financial Aid
Have you attended other colleges/universities? Yes No
If yes, please provide name and state :: Name: State:
If yes, are your transcripts on file with the Admissions & Records office? Yes No

What is your educational objective?
If pursuing a degree, certificate, or transfer, what is your major?
Please submit your question to an online counselor ::