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PERSONALPleaseprovideyourpersonalinormation.Typeorprintyournameexactlyasitappearsinyourpassport.LastFamilyNameFirstGivenNameMiddleNameMaleFemaleDateoBirthMonthDayYearCountryoBirthCountryoCitizenshipHomeCountryAddressCityProvincePostalCodeCountryTelephoneNumberincludeareacodeEmail1.WhatwillbeyourselectedmajorareaostudyatUCR2.WillyoubethefrstinyouramilytoattendcollegeYesNo3.AreyousponsoredbyanagencyembassypartneruniversityYesNoINOskiptoImmigration.IYESpleaseprovideNameoAgencyEmbassyorPartnerUniversityAgencyIDCountryMailingStreetAddressCityProvincePostalCodeOptionalIyouwanttoauthorizeustoreleaseyourpersonalfnancialrecordstoyouragentrepresentativepleasesignhereFormoreinormationonstudentrecordprivacyStudentSignatureDateseehttpwww.cnc.ucr.edusaisprivacy.html.SpecialAPPProgramApplicationIMMIGRATIONDoyouneedanI-20YesNoIYESyouMUSTattachabankletterseeApplicationProcessonpage21todeterminetherequiredamountoryourbankletterincludingdependentsyouwishtobring.NOTEYoumustattachcopiesoyourpassportinopageandthesameoranydependentswhowillaccompanyyou.1.AreyoufnanciallysponsoredbyanagencycompanyorembassyYesNoIYESyouMUSTattachaletterosponsorshipontheorganizationsletterhead.INOskipto2.2.AreyoutranserringromanotherU.S.institutionYesNoINOskipto3.IYESpleaseprovideNameAddressoCurrentSchoolTelephoneandorFaxnumberincludeareacodeNOTEYoumustattachcopiesoallyourI-20sromotherschoolstherontbackoyourI-94cardandyourF-1visa.3.ThisStatementoFinancialSupportmustbesignedbythepersonwhoisfnanciallyresponsibleoryou.IyouarefnanciallyresponsibleoryourselyoumustsignitIhavereadtheinormationregardingthecostotuitionandlivingexpensesortheperiodostudyattheUniversityoCaliorniaRiversideExtension.IcertiytheseundsareavailableandIacceptullresponsibilityortheseexpenses.NameoPersonOrganizationFinanciallyResponsibleRelationshiptoStudentSignatureDatePleasechooseyourprogramstartdateSeptember2015September2016WillyouattendIntensiveEnglishbeoreAPPYesNoPleasechooseyourprogramstartdateJanuary2015April2015July2015CERTIFICATESTESTS1.HaveyoucompletedacertifcateordiplomaprogrambeoreIsopleasecompletetheinormationbelow.SchoolNameCityStateCountryLanguageoInstructionGradeSystemBeginDateEndDateDiplomaCertifcateNameandDateocompletion2.HaveyoutakenordoyouplantotakeanystandardizedtestsListanySATACTSATSubjectExamsTOEFLIELTSIBorAPexams.TestNameDateScoreDateScoreDateScoreForofceuseonlyApplicationReceivedbyIEPromUGAGPAApplicationReceivedbyIEPromStudentApplicationtoUGAorReview