Senior Summit Application

Thank you for your interest in EAOP's Senior Summit!

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. If you have any questions, please contact Esmeralda Trejo via email (etrejo@ucr.edu) or phone (951.827.6228).

MANDATORY Parent-Student Orientation -  Saturday, July 14 or Tuesday, July 17
Program Dates -
 Wednesday, August 1st - Friday, August 3rd  (100% ATTENDANCE REQUIRED)

* 1. Student's First Name:

* 2. Student's Last Name:

* 3. Student's date of birth:

Date:

* 4. Student's Gender

* 7. Student's High School Graduation Year:

* 8. Student's T-shirt Size (Adult Size):

* 9. Do you belong to any of the followingCommunity Based Organizations or Partnerships?

* 10. Student's Primary Email: 
(you will receive an email confirmation to this email once we receive your waivers)

* 11. Please confirm Student's Email:

* 12. Student's Primary Phone Number:

* 13. Parent's Primary Email:
(you will receive an email confirmation to this email once we receive your waivers)

* 14. Parent's Primary Phone Number:

* 16. Are you interested in receiving information specific for Undocumented, DACA, Dreamer, or AB540 students?

* 17. What is your Major/Career interest? (Can list multiple, or "undecided")

* 18. Are you considering attending a community college for your first two years of college?

* 19. Please select the type of colleges you plan to apply to during your senior year. Check all that apply.

* 20. Do you plan on attending a 4-year college/university immediately after you graduate high school?

* 21. MANDATORY PARENT/STUDENT ORIENTATION:
To be certain that all parents receive crucial information about Senior Summit, UCR campus, and rules and regulations, parents/legal guardians and Senior Summit participants must attend ONE of the orientations.


Please select the orientation the student and at least one parent/guardian will attend:

* 22. After clicking the submit button you will be redirected to the Senior Summit Student Packet and Mandatory Forms. To participate in the event, students must return the waivers to the EAOP office via e-mail, fax, mail, or drop off by the June 22 deadline.

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