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UNIVERSITY OF CALIFORNIA APPLICATION FOR ADMISSION _-: UNDERGRADUATE __ 1968-69 es PART A . Before filling out this a lication, please read carefully x Admissions Cireular. PP P aad The date that a your request for an application was received filing period, the first day of that period. If you. wish to maintain the priority of that date, you must return the completed ‘application to the OFice of Admissions within the twenty days following. Do not file more than one ‘ applicatica for admission to the University of California, Fees atcompanying duplicate or multiple applications wili not be refunded. Please type or prist in ink, ; i‘ 1 i] 3. ‘ « *, t bat Cashier ‘ yee an application for admission to tie -Geirkeley. campus of the University of California for: Admiisions °° iv Fall Quarter 1963 (September) 1) Winter Quarter 1969 (j anuary) Q Spring Quarter 1969 (March) (G Summer Quarter 1969 (June) (Berkeley, Davis, Los Angeles, and ee Kxame, Give full iegal name. Do not use nicknaines, abbreviations, or initials. : Santa Barbara only) : ; _ Soltvsik.. otricia. Mons MSs. & Miss. Social Security No. A659 ~The t= 4 % Pomiy Same First Naruse . Middl Name | OF Mrs. ; . : will appear on previous educational records if different from above. ee saeereementevncnntt garetts eneenecnns cement MESS, OF ane _ any change of address or telephone number) ei pe en <A ae C20 G2 eens poseeed Chr. Le tenn GOT... Tetegnont No. ZOS.~ Vo IS. < Member Ss : hr ‘ No .- ' ' State Zip Code Aron Code Hwaneat mailiog address, (Please notify the Of ee OF Admissions at once of any change of address or telephone number.) Lo - moe i FPALS Buble Dr. GOST. SATE ARBAB.» LOGIE... $ICLE... Telephone NodQF > GEF-2GE | . _ Fember Street ; ity . - 7 » County : oe “Btato . -” Big Cude : : ares Code No. q ¥ | eel Bitthplaceidard aveeiza.. COLLE iki thé Countey of Citizenship__Cle Se . ‘ : se * Moath Day Year . City State a ae oo ae ete a be : Se fm ares citizen of a foreign country, what type of visa do you have? sortettteersereenrnnnene OF EXPECE £0 secure) —— og Caters ior School) and Curriculum {or major) in which you plan to enroll. A list of Four-Year Undergraduate Programs 2ppears‘in the Under is & Pwiwase Adstissions Circular, If necessary refer to the Universi ty cataloguesor bulletins, : . a -. z ene ccocncenccenevnsresene Curriculum or Major. Bilagierl SCieMes = Agric., Cowell, Letters & Science, Revelle, etc, - * §ticultural Science, History, ete. plied for admission to the University of Catifornia {excluding summer sessions or University Extension)? Yes. Not Flew snus Previously ap , MA =Rich cam PU sageen need sseseneeemen ses cee E ¢. een . vsstet—lewneerecetnere vane Year..- _— 2 a, a tap CAREFLELY: List in chro er all schools attended since conrpletion of the eighth grade, including the school you are now altend- - - = on WSs" thess of ieneth of ittendante, whether or not any courses were completed, and v ‘ TF Nichs arty vanged standing cree. Include’ attendance at the University of Calif ot sision (summer'sessit . i teat ina merits, the Olfce of Admissions on the caw 7 MT cate Note the statemegt:immediate whether or not vat believe the record will affect your ‘ nother college or university yo! i us where this zpplication is filed, indicating the courses you are takiug and the school in “wh Y preceding your signature on Part A of this application. Lo - : “wl. Collere, or Caiversity ae . Location ‘Joc! Fron Te. ° Leagth of Diploms or _*_ >. \emed Forces Record - TT City ve State Month Yeur | Month Teur | Atteridance f- 'Devree