P&HCC PROMISE Application

Please complete each section. Note that all sections are required in order to be accepted in the program.

Name:

First Name

Middle Name

Last Name

P&HCC Account:

If you have already applied to P&HCC, please enter your student ID (EMPLID) number or your username.
EMPLID or Username
If you have not applied you can do so HERE. If you do not know your EMPLID or username, please see the P&HCC Career Coach at your high school or Look up my username

Date of Birth:

Month

Day

Year

High School

Graduation Year:

Contact Information

phone

Street Address
Apt, ste, lot
City State Zip