Testimonials
Personal/Contact Information
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Female
American Indian/Alaskan Native
Hispanic/Latino
American Asian
Native Hawaiian/Pacific Islander
Asian
Other (Please specify below)
Black
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Caucasian/White

Students must be 16 years old before the start of the program in order to participate.

Please choose your first priority for session scheduling:

High School Information
Emergency Contact Information
Are either of your parents an employee of the University of California? Yes No
Financial Information

Personal Responses

These short essays will help to learn more about you.

1. Share one memorable experience. What did you learn from this experience?

2. What makes you a good leader?

3. What do you hope to learn this summer?

4. How will receiving a program scholarship impact you?

By typing my name below, I certify that all the information provided in this application is correct:

Nothing but the absolute best in patient care & treatment.

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