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PERSONALPleaseprovideyourpersonalinormation.Typeorprintyournameexactlyasitappearsinyourpassport.LastFamilyNameFirstGivenNameMiddleNameMaleFemaleDateoBirthMonthDayYearCountryoBirthCountryoCitizenshipHomeCountryAddressCityProvincePostalCodeCountryTelephoneNumberincludeareacodeEmail1.HaveyouappliedtooneoourprogramsbeoreYesNoIYESprovideyourStudentIDINOskipto2.2.IsyourmailingaddressthesameasyourhomecountryaddressYesNoIYESskipto3.INOpleaseprovideMailingStreetAddressCityProvincePostalCodeCountryTelephoneNumberincludeareacode3.WhatisyourhighestlevelostudycompletedHighSchoolUniversity4.Howdidyoufrsthearaboutus5.FromwhomdidyoureceivethisbrochurePleasemailaxoremailyourapplicationmaterialstoInternationalEducationProgramsUCRiversideExtension1200UniversityAve.RiversideCA92507-4596U.S.A.Phone1-951827-4346Fax1-951827-5796Emailiepapplicationucx.ucr.eduProgramApplicationITTandUCPonlyPROGRAMPleasetelluswhichprogramyoudliketoattend.Seepage4ordateslengthsees.Quartere.g.WinterYeare.g.2015IdentiyyourprogramITTorUCPLength10-weekor12-weekStartDateMonthDayYear1.AreyousponsoredbyanagencyembassypartneruniversityYesNoINOskiptoimmigration.IYESpleaseprovideNameoAgencyEmbassyorPartnerUniversityAgencyIDCountryMailingStreetAddressCityProvincePostalCodeOptionalIyouwanttoauthorizeustoreleaseyourpersonalfnancialrecordstoyouragentrepresentativepleasesignhereFormoreinormationonstudentrecordprivacyStudentSignatureDateseehttpwww.cnc.ucr.edusaisprivacy.html.IMMIGRATIONDoyouneedanI-20YesNoIYESyouMUSTattachabankletterseeApplicationProcessonpage21todeterminetherequiredamountoryourbankletterincludingdependentsyouwishtobring.NOTEYoumustattachcopiesoyourpassportinopageandthesameoranydependentswhowillaccompanyyou.1.AreyoufnanciallysponsoredbyanagencycompanyorembassyYesNoIYESyouMUSTattachaletterosponsorshipontheorganizationsletterhead.INOskipto2.2.AreyoutranserringromanotherU.S.institutionYesNoINOskipto3.IYESpleaseprovideNameAddressoCurrentSchoolTelephoneandorFaxnumberincludeareacodeNOTEYoumustattachcopiesoallyourI-20sromotherschoolstherontbackoyourI-94cardandyourF-1visa.3.ThisStatementoFinancialSupportmustbesignedbythepersonwhoisfnanciallyresponsibleoryou.IyouarefnanciallyresponsibleoryourselyoumustsignitIhavereadtheinormationregardingthecostotuitionandlivingexpensesortheperiodostudyattheUniversityoCaliorniaRiversideExtension.IcertiytheseundsareavailableandIacceptullresponsibilityortheseexpenses.NameoPersonOrganizationFinanciallyResponsibleRelationshiptoStudentSignatureDatePAYMENTPayyourapplicationeeswithacashierscheckmoneyordermadepayabletoUCRegentsorbyVisaorMasterCard.CreditCardNumberCardholdersNameExpirationDate3-DigitSecurityCodeAuthorizingSignatureIauthorizeUCRtocharge200EnrollmentApplicationFee200HousingPlacementFeeOtherORMoneyOrderorCashiersCheckenclosedREQUIREDIcertiytheinormationonthisentireormiscorrecttothebestomyknowledge.SignatureDatePLEASENOTEThisapplicationisorInternationalTranserTrackITTandUniversityCreditProgramUCPapplicantsonly.IyouareapplyingortheAdmissionPreparationProgramAPPyoumustcompletethespecialAdmissionPreparationProgramAPPApplication-pgs.23-26.