coursework statement
winter quarter 2014
Name: _______________________________
UCLA ID: _____________________________
Major: _______________________________
Application ID: __________________________
Email: _______________________________
Daytime Phone: _________________________
Please complete this form and fax or mail it to UCLA Undergraduate Admissions and Relations with Schools (contact information
below) in the envelope provided by December 10, 2013.
Indicate the coursework you have completed, are currently enrolled in, and/or plan to take prior to your enrollment at UCLA:
Term
Fall
Year
College Name
Dept
2013
Semester
Course #
Course Name
Quarter
Units
Grade
Total Units:
No Courses This Term
vIf you are transferring from a California Community College:
Will you have completed the Intersegmental General Education Transfer Curriculum [IGETC]?
If yes, you must ask your Community College records office to send us official certification of IGETC completion.
Yes
No
vIf you are transferring from another UC Campus:
Will you have satisfied the General Education [GE] requirements for the UC campus you currently attend? If yes, you
must ask your current campus to send us official verification that you have completed the GE requirements.
Yes
No
If there are any further changes in your coursework, you must notify us in writing (see instructions for reporting changes and/or poor
grades on your Provisional Admission Contract).
I certify that all the information provided is correct.
Signature:__________________________________________________Date:_______________________
Make a copy of this document for your records. Fax to 310.206.1206 or mail to the following:
Undergraduate Admissions and Relations with Schools
1147 Murphy Hall
Los Angeles, California 90095-1436
contact information
Undergraduate Admissions and
Relations with Schools
1147 Murphy Hall
Los Angeles, California 90095-1436
310.825.3101
310.206.1206 [fax]
newbruins@saonet.ucla.edu
admissions.ucla.edu
General Information
405 Hilgard Avenue
Los Angeles, California 90095
310.825.4321
ucla.edu
Alumni Association
James West Alumni Center
310.825.2586
alumni.ucla.edu
Dashew Center for International
Students and Scholars [DCISS]
Bradley International Center
310.825.1681
www.internationalcenter.ucla.edu
Writing Programs
146 Humanities Building
310.206.1145
wp.ucla.edu
Financial Aid Office
A-129 Murphy Hall
310.206.0400
fao.ucla.edu
General Catalog
registrar.ucla.edu/catalog
Housing Assignment Office
360 De Neve Drive
310.206.7011
housing.ucla.edu
Office of Students with Disabilities [OSD]
A-255 Murphy Hall
Voice 310.825.1501
TDD 310.206.6083
www.osd.ucla.edu
New Student and Transition
Programs [Orientation]
201 Covel Commons
310.206.6685
www.orientation.ucla.edu
Registrar’s Office
1113 Murphy Hall
310.825.1091
registrar.ucla.edu
Schedule of Classes
registrar.ucla.edu/schedule
Student Financial Services [Billing]
1121 Murphy Hall
310.825.9194
www.sfs.finance.ucla.edu
Summer Sessions
1332 Murphy Hall
310.825.4101
summer.ucla.edu
Transportation Services
555 Westwood Plaza
transportation.ucla.edu
UCLA Police Department
601 Westwood Plaza
310.825.1491
ucpd.ucla.edu
UCLA Store
Ackerman Union
310.825.7711
uclastore.com
Veterans Resource Office
310.206.6915
www.veterans.ucla.edu