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[Application Form on reverse side]

UNIVERSITY OF CALIFORNIA

Name (signed) in full:

Permanent P. O. Address:

APPLICATION FOR ADMISSION

Degrees:

[SUMMER SESSION OF 1912]

Age (if under 21 years):

High schools, academies, and colleges or universities attended, with periods and dates of attendance; also dates of graduation.

(Answer fully):

References:

(Avoid initials and other abbreviations)

U. C. Summer Sessions attended-years

Occupation:

(For each degree give institution and date)

(Names and addresses of school officers or others from whom information about you may be obtained)

Specify the summer courses in which you desire to enroll:

(It is understood that this list is subject to change)

Place and date of writing this application:

Applications should, if possible, be filed with the Recorder of the Facul ties. Berkeley, California, on or before June 5th. They may be sent by mail. In case of adverse action by the Faculty upon an application for admission to the Summer Session, the applicant is notified immediately, by mail; in other cases no acknowledgment or other notice is sent. Additional application forms may be obtained by addressing the Recorder of the Faculties.

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