Community Learning Center for Children and Youth

Mailing Address
Cleveland State University
2121 Euclid Avenue, JH 130
Cleveland, OH 44115

Campus Location
2485 Euclid Avenue
Julka Hall, Room 130
Cleveland, OH 44115

Phone: 216.687.4768
communitylearningctr@csuohio.edu

Student Intake Questionnaire

  • Start
  • Projects
  • Student Interests
  • Demographics
  • Complete

Contact Information

Background Information

7. Where are you enrolled?

7b. Current Academic Level/Status:

7c. What is your major/license?

8. Do you have an FBI/BCI Background check?

9. Means of transportation?

10. Are you currently in a field Class?

Examples: Rotation 1-3, Step 1 (EUT 201/202), Classroom, EDB 242, Interactions, Yes but I do not know the name of the course.

11. Do you speak another language?

Mailing Address
Cleveland State University
2121 Euclid Avenue, JH 130
Cleveland, OH 44115

Campus Location
2485 Euclid Avenue
Julka Hall, Room 130
Cleveland, OH 44115

Phone: 216.687.4768
communitylearningctr@csuohio.edu