UC Summer Session

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* Full Legal Name

First Name:

Middle: (if none, put none)

Last:

* Gender:  Male  Female

* Birthdate: Month 01 02 03 04 05 06 07 08 09 10 11 12 Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Name on previous academic records if different from above
First Name:	Middle Name:	Last Name

* Permanent Address

Street (including apt. # and/or PO Box):
City:	State	Zip:	Country:
Phone Number: ()  -	Non-US Phone Number:

* Email Information

Email:

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* Enrollment

Are you pursuing a college degree during the regular (Fall, Winter, Spring) academic year?   Yes    No

If yes, last enrolled:   Fall     Winter     Spring     Year:

If yes, where? If not at a UC, use "Other"  UCLA  UC San Diego  UC Santa Cruz  UC Davis  UC Merced  UC San Francisco  UC Irvine  UC Riverside  UC Santa Barbara  UC Berkeley If you attended a UC Campus, enter your student ID:  Other: Outside of US 2-Year college Where?   Other 4-year college Where?   High School None

Will you be a NEW admit to UC for the Fall 2012 Quarter:   Yes     No

If yes, select admission type: Freshman Admission Transfer Student Grad Student Don't Know Yet

If yes, where?  UCLA  UC San Diego  UC Santa Cruz  UC Davis  UC Merced  UC San Francisco  UC Irvine  UC Riverside  UC Santa Barbara  UC Berkeley

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Processing

Your application form will be processed and a student record will be set up in the UCSC student enrollment system. The Summer Session Office will send you, via email, your UCSC student ID number and password, along with directions on accessing the system to enroll in classes. Please allow a minimum of 3 business days to receive your ID number and password this information. Every effort will be made to process your application within this time frame.

Complete one application form only - either on-line, or by submitting this form to the Summer Session Office.

Agreement

I hereby apply for registration in the 2012 Summer Session of the University of California, Santa Cruz, and understand that acceptance of this application does not admit me to a fall, spring, or winter quarter of the University. I obligate myself (even in the event of an early withdrawal) to pay all fees incidental to such enrollments as fixed by Summer Session and to abide by all University rules and regulations. I understand that all Summer Session fees must be paid in full according to the Summer Session payment schedule listed on the Summer Session website, summer.ucsc.edu.

I have read and understand the policies listed on the UCSC Summer Session website, summer.ucsc.edu, regarding academic information, enrollment, fees and refunds. I understand if I enroll in any course(s) and later drop all courses, I will be charged a $50 non-refundable cancellation fee.

May 16, 2012; 5:26 am   *   I agree   

When you hit submit, you will be taken to a secure site where you will enter your credit card information to pay the $10 application fee.

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