P&HCC/HARVEST SEED

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 at the following link: Complete my application.
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