Application Form Trinity-in-San Francisco Program

APPLICATION FORM TRINITY-IN-SAN FRANCISCO PROGRAM PLEASE PRINT AND SEND HARDCOPY to: Trinity in S.F. 1735 Franklin Street San Francisco, CA 94109 (Please see separate application for Summer Course 2002)
Name: _____________________________________________ Sex: M F Social Security Number: _____________________________ Date of Birth (Month-Day-Year): ______________________ Place of Birth: ____________________________________ Country of Citizenship: ______________________________ If not U.S., type of visa: _____________________________ Ethnic origin: American Indian or Alaskan Native Hispanic Asian or Pacific Islander Caucasian (non-Hispanic) African-American (non-Hispanic) Urban Forum Preference (please list your first and second choices): Fall 2002: _______Gay/Lesbian History, Culture and Community Forum _______Culture Forum Spring 2003: _______City Design Forum _______City/Regional Government Forum _______Culture Forum College or University Presently Attending: _________________________________ Expected Year of Graduation: _______ E-mail address_________________________ Address (School): ____________________________ ____________________________ ____________________________ School Phone: _____________________________ Address (Summer): __________________________ _____________________________ _____________________________ Summer Phone: ____________________________ Major: ___________________________________ Department Head (or Academic Advisor, if no major declared): __________________________ Phone: __________________________ Faculty Reference (students from colleges and universities other than Trinity must request a letter from this reference and have it submitted as part of the application process; Trinity students need only ask a faculty member to be a reference and request his or her permission to be contacted as part of the admissions process) Faculty Reference: _____________________ Phone: ______________________________ If check is not enclosed, Comprehensive Fee for the Program Billed to: Street Address: ________________________ City: ________________________________ State: _______________________________ Zip: _______________________________ In case of emergency, please notify: Name: __________________________________ Relationship: ______________________________ Daytime Phone Number:____________________________ Evening Phone Number: ____________________________ Street Address: ___________________________________ City: ____________________________________ State: ___________________________________ Zip: ____________________________________ Please remember to include your 500 word personal statement with your application. Students from colleges and universities other than Trinity, please also include the following I authorize Trinity College to send a transcript of my grades to my home college at the end of the term. Application Deadline for Fall 2002 term: March 18, 2002 (priority); April 8, 2002 (secondary) Application Deadline for Spring 2003 term: October 21, 2002 (priority); November 18, 2002 (secondary)
Trinity College and its Trinity-in-San Francisco Program does not discriminate on the basis of age, race, color, religion, sex, sexual orientation, handicap or national or ethnic origin in the administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other College administered programs.
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