CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION

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California State University, Fresno

METRO Program Application

PERSONAL INFORMATION

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION Name:

Last First MI

ID# : ______________________

Gender:  Male  Female

Residency Status:

 U.S. Citizen  Permanent Resident

If applicable, Permanent Resident Registration Number : ______________________

Date of Birth: __________________________________

Place of Birth : _________________________________

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION

CONTACT INFORMATION

Mailing Address: ______________________________________________________________________________________________

Street Apt # City State Zip

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION Home Phone: ( ) — Cell Phone: ( ) — Email: ___________________________

 Check here if Address 2 is same as above

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION Permanent address

Street Apt # City State Zip

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION

PERSONAL BACKGROUND

Ethnicity - How do you describe yourself? Please select only one:

 Asian  Southeast Asian  White  Alaska Native  African American/Black  Hispanic/Latino

 Native American (Specify nation): _____ ____________  Native Hawaiian or Pacific Islander (Specify): ________________

 Bicultural (Specify): _________________  Other (Specify): ________________________

What is the primary language spoken in your home? _________________________________

A CADEMIC BACKGROUND

Please check what applies to you: Expected Graduation Date____________

 Community College Student - I am transferring to Fresno State in 201 _____

Community College Currently Attending: _____________ Registered Number of Units: _________ GPA: ________

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION  Fresno State Student - GPA: _______Grade Level: ______ Expected Graduation Date:_______Registered Number of Units:____

List the highest level you have taken in the following subjects and grades received

Course Name (Example: Calculus, AP Biology etc.) Grade Received

Geology: ____________________________________ ________

Chemistry: ____________________________________ ________

Math: ____________________________________ ________

Physics: ____________________________________ ________

Other Science: ____________________________________ ________

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION

ACTIVITIES/HONORS

List any extracurricular activities in which you have participated while attending high school or community college.

List any honors/awards you have received while attending high school or community college.

A CADEMIC AND CAREER GOALS

Please indicate your expected or current college major.

 Agricultural Science  Geology

 Biology  Geomatics Engineering

 Chemistry  Industrial Engineering

 Civil Engineering  Mathematics

 Computer Science  Mechanical Engineering

 Computer Engineering  Natural Science

 Environmental Science  Physics

 Other (specify): ________________________________________________

Career Objective: _________________________________________________________ (e.g. graduate study, work in industry)

CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION

How did you hear about the program?

 METRO Poster/flyer

 METRO Website

 From a friend

 From an instructor

 From a METRO student

 Other (please specify): _______________________________________________

Why are you interested in the METRO Center?

What do you know about the METRO Center?

PERSONAL STATEMENT (PLEASE TYPE)

In the space below or on a separate sheet of paper, please answer the following questions

What interests you about Geosciences?

Explain how your family and/or community have influenced your personal growth and your decision to pursue a college degree.

Describe any challenges or obstacles you have had to overcome in order to pursue a science, technology, engineering or math (STEM) major.

The information I have submitted in my METRO Program Application is true and accurate to the best of my knowledge. I understand that to track the progress of METRO students and to evaluate program effectiveness, the METRO Center requires access to student information. Photographs and research abstracts may also be obtained for use by the METRO program in program dissemination materials such as websites, newsletters, and reports. I am aware of the provisions of the Family Educational Rights and Privacy act and hereby authorize the release of the requested information directly to the California State University, Fresno METRO Center (i.e. transcripts, letters of recommendation, etc.).

S CALIFORNIA STATE UNIVERSITY FRESNO METRO PROGRAM APPLICATION PERSONAL INFORMATION tudent Signature: Print Name: Date:

PLEASE MAIL YOUR APPLICATION AND TRANSCRIPTS (UNOFFICIAL ACCEPTED) TO:

ATTN: Ronna Crews - METRO Administrator

2576 E. San Ramon Ave M/S ST 90

Fresno, CA. 93740-8034

OR SAVE A COPY OF YOUR COMPLETED APPLICATION AND EMAIL IT TO: [email protected]

For more information about METRO call (559) 278-6076 or visit us online at http://www.fresnostate.edu/csm/geosciencesmetro/

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