Closes June 15- Online Registration & Waiver Forms must be submitted to complete your registration

Thank you for your interest in EAOP's College Prep Academy!
Upon completion of both the Online Registration Form and Waiver Forms, you will be given a confirmation email with further details closer to the day of the event.   You may scan and email completed waivers to eaop@ucr.edu
If you have any questions, please contact Elehna Robinson via email elehna.robinson@ucr.edu.

Please note the following MANDATORY dates and times:

Parent Meeting -
Saturday, June 30th 8:00 am - 9:30 am at UC Riverside, MSE 116.

Program Dates - Monday through Thursday from July 9th to July 19th from 8:00 am - 3:00 pm at UC Riverside.

* 1. Student's Primary Email Address:

* 2. Student's First Name:

* 3. Student's Last Name:

* 4. Student's High School Graduation Year:

* 6. Do you belong to any of the following Community Based Organizations?

* 7. Student's Primary Phone Number:

* 8. Parent's Primary Email Address:

* 9. Parent's Primary Phone Number:

* 10. Primary Language Spoken in Household:

* 11. Does the student need special accommodations due to a disability?

* 12. If yes, please specify need:

* 13. Do you have any dietary restrictions?

* 14. What math class do you anticipate enrolling in for Fall 2018 (next school year)?

* 15. What science discipline do you anticipate enrolling in for Fall 2018 (next school year)?

* 16. MANDATORY PARENT MEETING
(Saturday, June 30th from 8:00 am - 9:30 am)
This Parent Meeting is necessary for going over the details of the program, expectations both parents and students, and logistics of the event.  If a Parent cannot attend, the Student can come in their place. If neither the Parent or Student attends, they will be placed on the Wait List.

* 17. MANDATORY WAIVERS:
After clicking the Submit button below you will be redirected to another webpage where you can download the required forms to participate in College Prep Academy. These forms MUST be returned to our office no later than Friday, June 15th. Instructions on completing and returning the forms can be found in the packet. If you have any questions, please contact Elehna Robinson via email (elehna.robinson@ucr.edu). Your registration is not complete until we receive all completed forms.

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