* 1. What is your full name?

* 2. What is your UC email address?

* 3. What is your phone number

* 4. What is your major and/or program of college? (Please list department and college, if applicable.)

* 5. Describe why you want to participate in the "Experiential Learning Collaboratory: Generation Ali" class? (In your answer, be sure to include any unique experiences you may have that would add value to the class.)

* 6. Optional Question: Is there anything else you’d like to share about yourself and/your experiences?

* 7. The Fall '14 section of this class is scheduled to meet 1 time per week, on Friday mornings from 9:05 AM - 12:10 PM. Does this fit with your current class schedule for fall, or would you be able to adjust your schedule to make it possible?