If you are a current UCSC undergraduate student do NOT use this form.  You are already set up to be able to enroll in summer classes at my.ucsc.edu beginning April 20.


UCSC 2009 Summer Session Application Form

* Required fields

Last 4 digits of Social Security number:
 Previous UCSC ID:
W
Check this box if you do not have a Social Security Number: 

* Full Legal Name

First Name:
 Middle: (if none, put none)
 Last:
* Gender:
 Male  Female
* Birthdate:
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:
 Confirm Email:

* 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 2009 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

Security Note: All pages of this form are securely transmitted with SSL encryption, to protect your private information.

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. 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 2009 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.

July 04, 2009; 5:16 pm   *   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.

PLEASE REMEMBER, especially if you are using a public terminal, to exit/quit the browser when you are finished. This will help protect the security of your personal information.

Click here to completely clear this form: