UC Berkeley Washington Program
Preliminary Application

Note: Fields marked with an asterisk (*) are required.
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*Name	Mr. Ms.	*First Name	*Family Name
*Local Address
	*City	*State	*Zip
*Local Phone	Please format: 510-642-2000
*Email 1
Email 2 (optional)
*Student ID
*Major(s)
	*How many units will you have earned at UCB (excluding AP or transfer units) by the semester you want to go to DC?

*Semester you are thinking about going to DC (check all that apply): Spring 10 Fall 10 Spring 11 Fall 11

*Current class standing: Sophomore Junior Senior Graduating Sr.

*Semester/year you expect to graduate:

*Your GPA:

*Your College at UCB:

If you want to intern in an organization that requires a security clearance, have you begun the process of applying for clearance? Yes No

How did you find out about the UC Berkeley Washington Program? Please select all that apply.
ACADEMIC	undergrad advisor and/or department's e-mail listserve professor class announcement (by a program alum or staff member)
CAREER CENTER	Career Center fair (Nonprofit/Public Service Fair, Internship Fair, etc.) Career Center e-mail list serve or web page calendar of upcoming events Career advisor
DAILY CAL and KALX	Daily Cal article Daily Cal listing in the "Daily Calendar" section Daily Cal display ad KALX public service announcement
CAMPUS ORGANIZATIONS	presentation (by a program alum or staff member) at a club or fraternity/sorority Undergraduate Research Programs e-mail listserve or web page Undergraduate Research Apprentice Program (URAP) e-mail listserve public announcements at Cal sports events
CAMPUS EVENTS	Sproul Plaza table Office of Student Life's Resource Fair Cal Corps' Public Service Fair College of Letters & Science's Major Events fair Table at Cal Day (campus'annual weekend open house) Cal Leadership Symposium Calapalooza
POSTERS	Bulletin board in Wheeler Hall flyer in department flyer on campus shuttle bus flyer or announcement in your residence (dorm, Co-op housing, etc.)
OTHER	searching the web word-of-mouth (friend, classmate, etc.)

Submit your preliminary application

Please double-check your answers to verify their correctness. When you are finished, click "submit form."