Fall 2016 Interest Form

To participate in this program, students must:

Be in the 11th or 12th grade in high school.
Have the recommendation of their high school principal or counselor.
Have the consent of a parent or guardian if student is under age 18.
Have demonstrated adequate preparation in the discipline to be studied.
Have a cumulative 9-12 weighted GPA of 2.5 or higher on high school transcripts.
Be a legal California resident

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First Name

Last Name

Phone

Birth Date

Address

City

State

Zip

First Choice

First Class Choice

Second Choice

Second Class Choice

Third Choice

Third Class Choice

Academics