2017-2018 CSU UNDERGRADUATE

APPLICATION
SUBMITTED INFORMATION PRINTOUT
THIS IS FOR YO UR REC O RDS ONLY. DO NOT SEND TO THE C AM PUS!

Confirmation number: 0018-0F2017-2-11292016-37797055-36604718

Date submitted: November 29, 2016 at 6:34:08 PM
Payment type: Fee waiver

ENROLLMENT INFORMATION

Term applying for: Fall 2017

Intended major: Social Work (BA)

Emphasis/Concentration:
Alternate major: Psychology (BA)

What is your degree objective? BA

Teacher or other credential program: Not interested in a credential program

Entry status/Total college transferable units: Graduating high school senior with college credit

When did you last apply to San Jos State University? Never applied

NAME AND ADDRESS

Legal name: Lopez, Laura

Current mailing address: 265 S 36th St, San Diego, CA 92113

Permanent address: 265 S 36th St, San Diego, CA 92113

Primary telephone: (619) 370-0281

Cell phone: (619) 370-0281
E-mail address: llopez92699@gmail.com
PERSONAL INFORM ATION
Social Security number: XXX-XX-0922 (only the last four digits shown for security purposes)
California Statewide Student Identifier (SSID): 7069721681
Date of birth: 9/26/1999
 Place of birth: San Diego, CA
Country of citizenship: United States of America
Citizenship status: U.S. citizen
County/State/Country of permanent residence: San Diego county
Parents'/Guardians' highest levels of formal education:
Parent/Guardian 1: High school graduate
Parent/Guardian 2: No high school
Dependent students:
Total family income for 2015: $28,000
Total size of parents/guardians' household in 2015: 2
Do you have the interest and ability to participate in NCAA-sanctioned intercollegiate athletics
competition? No

CALIFORNIA STATE RESIDENCY INFORMATION

What U.S. state/territory does your parent/guardian regard as his/her permanent home? California
Does your parent/guardian claim California residency? Yes
Has your parent/guardian lived in California continuously since his/her birth? No
If no, when did his or her present stay in California begin? 8/26/1998

DEMOGRAPHIC INFORMATION

Question 1: Do you consider yourself Hispanic or Latino? Yes

What category best describes your background? Mexican
Question 2: Which of the following groups do you consider yourself to be a member? None of the
above
Question 3: Race/Ethnicity reporting preference: Hispanic or Latino

Question 4: Sex: Female

Question 5: U.S. Military Information

Have you ever served in the U.S. Military? If YES, please choose your CURRENT status:No
Please indicate the branch of service for your above stated military status:
Are you the dependent of a US military service member, including active duty, National Guard,
Reserves, or a Veteran discharged from military service? No

Parent/Guardian 1 name: Lopez, Rosario Monica

Current mailing address: 265 S 36th ST, San Diego, CA 92113
Home telephone: (619) 508-7566
Cell phone: (619) 765-9566
E-mail address: monyvera73@gmail.com

Include in university/campus communications? Yes

HIGH SCHOOL INFORMATION

TERM D ATES OF
HIGH SCHOOL LOC ATION
TYPE ATTEND ANCE
SAN DIEGO SCIENCE & TECHNOLOGY (CEEB: SAN DIEGO, Semester 9/2013 to 6/2017
053903) CA
High school graduation date (or expected graduation date): 06/2017

Date taken/scheduled: 10/1/2016

SAT Scores Critical reading: , Math: , Writing: , Reading/writing score (3/2016 and after): 540,
Math score (3/2016 and after): 530

Date taken/scheduled: 10/22/2016

ACT Scores English: 23, Math: 18, Reading: 18, Science: 20, Composite: 20, Writing: , Writing
(9/2015 and after): 7

COLLEGE INFORMATION

INSTI TUTION / LOC ATI O N / D ATES OF UNI TS / TERM GP A / GR ADE DEGREE FEE
ATTEND ANCE TYPE POINTS E ARNED ST ATUS

SAN DIEGO CCD - CITY COLLEGE 3 completed 3.00 GPA None Resident
California / CEEB: 4681 3 attempted 9 grade points
2/2016 to 5/2016 Semester
calendar

SAN DIEGO CCD - MESA COLLEGE 4 completed 3.00 GPA None Resident
California / CEEB: 4735 4 attempted 12 grade points
9/2015 to 1/2016 Semester
calendar

You have indicated that you have earned college credit through the following program(s):
College Board Advanced Placement (AP)

HIGH SCHOOL PREPARATION 1

SOCIAL SCIENCE/U.S. HISTORY/GOVERNMENT COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

10 2014- Modern World History Semester A A

15 & Geography 1,2
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

11 2015- AP Human Geography Semester B A Fall/Spr

(AP)
16 (AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)
11 2015- AP United States Semester A A Fall/Spr
(AP)
16 History (AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AP Government and Semester Prog Fall

(AP)
17 Politics United States
(AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

Total Social Science/U.S. History/Government semesters: 7

ENGLISH COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

9 2013- English 1,2 Semester A B

14 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

10 2014- English 3,4 Semester A A

15 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

11 2015- AP English Language Semester A B Fall/Spr

(AP)
16 and Composition (AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AP English Literature Semester Prog Plan Fall/Spr

(AP)
17 and Composition (AP)
SAN DIEGO SCIENCE
 & TECHNOLOGY
(CEEB: 053903)

Total English semesters: 8

M ATHEM ATICS COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

9 2013- Algebra 1,2 Semester A A

14 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

9 2013- Geometry 1,2 Semester A B

14 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

10 2014- Intermediate Algebra 1- Semester B A

15 2
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

11 2015- Precalculus 1-2 Semester A A

16 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

11 2015- Precalculus 1-2 Honors Semester A A Fall/Spr

(HONORS)
16 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AP Calculus AB (AP) Semester Prog Plan Fall/Spr

(AP)
17 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)
 Total Mathematics semesters: 12

HIGH SCHOOL PREPARATION 2

BIOLOGICAL SCIENCE COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

10 2014- Biology 1,2 Semester A A

15 SAN DIEGO SCIENCE &
TECHNOLOGY (CEEB:
053903)

Total Biological Science semesters: 2

PHYSICAL SCIENCE COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

11 2016- Chemistry 1/2 Semester A A

17 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

11 2016- Physics 1,2 Semester A A

17 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AP Environmental Semester Prog Plan Fall/Spr

(AP)
17 Science (AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

Total Physical Science semesters: 6

LANGUAGE OTHER THAN ENGLISH (LOTE) COURS ES
 Grades earned Honors/
Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

11 2014- Waiver of LOTE Semester Pass Pass Pass Pass

15 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AP Spanish Language Semester Prog Plan Fall/Spr

(AP)
17 and Culture (AP)
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

Total Language Other Than English (LOTE) semesters: 6

VISUAL/PERFORMING ARTS COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

9 2013- Art 1,2 Semester A A

14 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

9 2013- Computerized Graphic Semester A A

14 Design 1,2
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

10 2014- Digital Art and Mixed Semester A A

15 Media
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)
12 2016- Technical Theater 1,2 Semester Prog Plan
17 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

Total Visual/Performing Arts semesters: 8

COLLEGE PREPARATORY ELECTIVE COURSES

Grades earned Honors/

Grade Term Sumr Sumr AP/IB/
Fall Spring
level Year Title type 1 2 College

10 2014- Computer Science Semester A A Fall/Spr

(HONORS)
15 Principles 1,2
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- AVID 12 (AVID) Semester Prog Plan

17 SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- Broadcast Journalism Semester Prog Plan

17 1,2
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

12 2016- Principles of Semester Plan

17 Economics 1
SAN DIEGO SCIENCE
& TECHNOLOGY
(CEEB: 053903)

Total College Preparatory Elective semesters: 7

High school GPA: 4.19

Additional non-A-G courses: Anatomy and Physiology 1,2

EDUCATIONAL OPPORTUNITY PROGRAM (EOP)

Are you interested in applying to EOP? Yes
APPLICATION FEE WAIV ER
APPLICATION FEE WAIVER PROCESSED
Date processed: Thursday, October 20, 2016 @ 8:04 AM Pacific Time
Application fee waiver request status: GRANTED

If you have qualified for an application fee waiver, remember that it is a TENTATIVE decision made
by this online application. The final decision is still made by the university.

Do you want to apply for an application fee waiver? Yes

Are you a veteran of the U.S. armed forces? No

Are you a foster youth, orphan, or ward of the court or were you prior to age 18? No
Do you have legal dependents other than a spouse? No
Are you married? No

Total family income for 2015 (taxed and untaxed): $28,000

Total size of parents' household in 2015: 2

THIS IS FOR YO UR REC O RDS ONLY. DO NOT SEND TO THE C AM PUS!