Name: School:
Address: City: Zip Code: Gender: Male Female
Home Phone: Cell Phone: Email:
To which other Universities or Colleges did you apply?
Admitted? - yes no wait list
To which California Community Colleges did you apply?
I will not enroll in school this fall. My plans are:
Work
Other:
This Fall I will enroll at:
Reason(s) for selecting this school (check all that apply): Proximity to Home Financial Aid Offer Housing Options Major Other:
Intended Major:
Participation in Educational or Academic Programs
I participated in the following programs and dates. (Check all that apply and when).
ATDP COSMOS MESA
EAOP PCA PUENTE EAOP SAT Academy
UCB Summer Sessions School Workshops Academic Advising College Application
Personal Statement Financial Aid Concurrent Enrollment
GPA:
Completed A-G coursework? Yes No
Completed Algebra 1 in (with a C or higher): 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade Other
Did you take Community College class? 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade
List courses taken & term including year (e.g., Fall 08, Spring 09, Summer 09)
COURSE: TERM: COLLEGE:
Please indicate which entrance exam you took. List the score if available (put highest score if taken more than once).
SAT Reasoning | Score: Date:
ACT w/ writing | Score: Date:
SAT Subject | Subject: Score: Date:
Did EAOP help you reach your educational goals?
Please explain: