Name: Email: Birthdate: HS Graduation Date: Home Address: Home Phone: NCAA ID: Cell Phone: State of Permanent

Residency: Parent 1 Name: Parent 1 Occupation: Parent 2 Name: Parent 2 Occupation: HS, City, State: Year of Admission for UC Davis: UCD First Major Choice: UCD Second Major Choice: High School Test Scores: All Junior College, College Institutions and Dates Attended: All HS and College Transcripts: Certificates or Degrees (IE Associates Degree) and Dates or Projected Dates: