EAOP Registration

The information provided will remain strictly confidential and will be used solely by UCSD/EAOP for statistical information, student follow-up, and evaluation to determine program participation. All information will be properly destroyed and disposed of when no longer needed.

Student Information
Name First Last
Gender Male Female
School ID
Birth Date / MM / DD YYYY
Email address
Password
Confirm Password
Student ethnicity

Please choose how you and your family identify themselves.
If Pacific Islander, Other Asian, Other Latin-American, or Other, specify
Mailing Address Information
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone - (###) - ### ####
School Information
School
Current grade level
H.S. Graduation Year
Current GPA
Are you part of your school's lunch program? Yes No
Leave blank if not sure or do not know.
If you are still in the 7th or 8th grade what high school are you planning to attend when you graduate?
EAOP Information
Please list two or three careers that interest you
What languages are spoken at home?
Of the following, who has completed a four-year degree from a university in the U.S.: Mother Father Step-parent Guardian
Highest level of education of Mother

If you are not sure or do not know please write "unknown"
Highest level of education of Father

If you are not sure or do not know please write "unknown"
Highest level of education of Step-parent

If you are not sure or do not know please write "unknown"
Highest level of education of Guardian

If you are not sure or do not know please write "unknown"

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EAOP Registration

EAOP Registration

Student Information

Mailing Address Information

School Information

EAOP Information