2011-12  application for freshman admission & scholarships

also available online at uw.edu/Apply/Freshman/Apply

Where you see the “Read Me” icon, find the instructions for that question on pages 7-9.
You are accountable for providing complete and accurate information. Omissions or inaccurate
information may result in the denial of admission.

HONORS PROGRAM FINANCIAL AID ON-CAMPUS HOUSING

You must submit a separate application directly Would you like the UW Office of Student Financial Aid Would you like UW Housing & Food Services to
to the Honors Program. See instructions, page 5. to inform you about UW financial aid programs? inform you about on-campus living and dining?
  I plan to apply also to the Honors Program.   Yes    No   Yes    No

Classification (C)  
C-1. Type:   First-time Freshman

C-2. Have you ever been or do you expect to be a Running Start participant (Washington State only)?   Yes   No

C-3. Have you ever been or do you expect to a participant in College in the High School or other college enrollment program?   Yes   No

Quarter (Q) 

Q-1. Quarter. For which quarter and year are you applying? Check one box only 

 SUMMER 2011  AUTUMN 2011  WINTER 2012

(begins June 2011) Deadline: Dec. 15, 2010 (begins September 2011) Deadline: Dec. 15, 2010 (begins January 2011) Deadline: Sept. 1, 2011

Major (MJ)
MJ-1. Major. What is your intended major or area of interest? (Choose a pre-major option if undecided.) 
Major code 

MJ-2. Alternate Major. If you have a second area of interest, please indicate it here. 
Major code 

Previous Attendance (PA)

PA-1. Have you ever applied for admission to the UW?   No   Yes: _______________________________ Quarter/Year
PA-2a. Have you ever attended the UW?   No   Yes
PA-2b. If yes, indicate the campus / type(s) of enrollment (check all that apply):
 Bothell     Day     Distance/Online Learning     ELP (ESL)     Evening     Extension     Summer     Tacoma     UW College in the High School

PA-2c. Date of First Attendance mm/yyyy PA-2d. UW Student Number (7 digits) ______________________________

Personal Information  (PI)

PI-1.  Male   Female
PI-2. Social Security Number PI-3. Date of Birth mm      dd      19     

PI-4. Legal Name:  To avoid confusion, use your full legal name whenever you contact Admissions.

Last (Family) Name First (Given) Name Middle Jr., etc.

PI-5. Other Name(s): If your name has changed, indicate your former full name(s).

Last (Family) Name First (Given) Name Middle Jr., etc.

Last (Family) Name First (Given) Name Middle Jr., etc.

UW Seattle Freshman Application  A1

 OFFICE USE ONLY

Address  (AD)
AD-1. Mailing Address 

Number and Street Apt.

City State (Province/Territory + Country if not U.S.) Zip+4 (or Postal Code if not U.S.)

AD-2. Permanent Address      Same as Mailing Address in AD-1    Different: complete the address information below

Number and Street Apt.

City State (Province/Territory + Country if not U.S.) Zip+4 (or Postal Code if not U.S.)

AD-3a. Telephone   AD-3B. Cell or Alternate Telephone 

AD-4. Email   @
This must be a valid address that you check regularly. If it changes, notify Admissions promptly. See instructions for further details.

Citizenship & Residency  (CR)

CR-1. Birthplace City and State Country if other than U.S. 

CR-2. Are you a U.S. citizen?   Yes: skip the next three questions.   No: go on to the next question.
CR-3. What is your country of citizenship?   Specify country

CR-4. What is your country of permanent residence?  Specify country

CR-5. Current or Expected Visa Type or Immigration Status 

 U.S. Permanent Resident/Immigrant Visa Registration Number: A# Date issued/to be issued mm      yyyy     

 Refugee  Political Asylee

 International Student: visa types F, J or B, H, L, M, R, TD, TN

 This is the wrong application. You need to complete the international application, available online at admit.uw.edu/Apply/International or contact Admissions.

 Other Visa Types (A,E,G,I,K,V) Visa Type and Number e.g., A-2, E-2, E-3, V-3      Date visa became (or will become) effective mm      yyyy     

 Other: any status not included above ________________________________________________________________________________

CR-6. Are you a resident of Washington State?     No   Yes: If yes, you must include dates of your most recent continuous residence in Washington State.

From mm      yyyy         to  Present or  to mm ________ yyyy _________

Special Programs  (SP)

SP-1. Will you be enrolling under the UW Faculty / Staff Tuition Exemption Program or Washington State Employees’ Tuition Exemption Program?     Yes   No

SP-2. Veterans Benefits. Would you like information about veterans benefits at the UW?     Yes   No

SP-3. Have you been in foster care in Washington state for at least one year since your sixteenth birthday?     Yes   No

UW Seattle Freshman Application  A2

 Family Information  (F)
Family Information. Residents of Washington State under the age of 25 must provide information about at least one parent or legal guardian, preferably both.
This information is required to determine residency classification. Omission of parent/guardian information will result in classification as a nonresident.
All applicants are urged to respond to as many of the questions in this section as possible. Family information provides context for better understanding an applicant’s
educational environment and circumstances. The information you provide in this section will not disadvantage you in the admission process in any way.

Parent / Legal Guardian

F-1a.  Mr. 1   Ms. 2   Mrs. 3   Dr. 4   Rev. 5   Other: 6 specify

F-1b. Name
Last (Family) Name First (Given) Name Middle Jr., etc.

F-1c.  Primary parent/guardian for contact with the UW    F-2. Relationship to you?   Mother 1   Father 2   Guardian 3   Other: 4  specify

F-3. Is s/he living?  Yes   No: skip to F-8.   F-4. Telephone    F-5. Email 

F-6. Address  Same as Mailing Address provided in AD-1  Same as Permanent Address provided in AD-2  Different:

Number and Street Apt.

City State (Province/Territory + Country if not U.S.) Zip+4 (or Postal Code if not U.S.)

F-7. Washington State resident?  No  Yes: From mm ________ yyyy _________ to  Present or  to mm ________ yyyy _________
You must include the dates of parent/guardian’s most recent continuous residence in Washington State.

F-8. What is parent/guardian’s highest level of formal education completed? (check one)
 Did Not Graduate High School 1   HS Graduate 2   Some College but No Degree 3   2-Year Coll. Degree 4   4-Year Coll. Degree 5   Postgraduate Study 6

F-9. If s/he attended college, list college(s) and degree(s):

COLLEGE U.S. STATE COUNTRY YEAR FROM YEAR TO DEGREE
(yyyy) (yyyy)

F-10. Did s/he attend the University of Washington?   Yes   No   F-11. Occupation
F-12. Do you authorize the release of information in your admission file to the parent/guardian named in F-1b?  Yes  No

Parent / Legal Guardian

F-13a.  Mr. 1   Ms. 2   Mrs. 3   Dr. 4   Rev. 5   Other: 6 specify

F-13b. Name
Last (Family) Name First (Given) Name Middle Jr., etc.

F-13c.  Primary parent/guardian for contact with the UW    F-14. Relationship to you?   Mother 1   Father 2   Guardian 3   Other: 4  specify

F-15. Is s/he living?  Yes   No: skip to F-20   F-16. Telephone    F-17. Email 

F-18. Address  Same as Mailing Address provided in AD-1  Same as Permanent Address provided in AD-2  Different:

Number and Street Apt.

City State (Province/Territory + Country if not U.S.) Zip+4 (or Postal Code if not U.S.)

F-19. Washington State resident?  No  Yes: From mm ________ yyyy _________ to  Present or  to mm ________ yyyy _________
You must include the dates of parent/guardian’s most recent continuous residence in Washington State.

F-20. What is parent/guardian’s highest level of formal education completed? (check one)
 Did Not Graduate High School 1   HS Graduate 2   Some College but No Degree 3   2-Year Coll. Degree 4   4-Year Coll. Degree 5   Postgraduate Study 6

F-21. If s/he attended college, list college(s) and degree(s):

COLLEGE U.S. STATE COUNTRY YEAR FROM YEAR TO DEGREE
(yyyy) (yyyy)

F-22. Did s/he attend the University of Washington?   Yes   No   F-23. Occupation
F-24. Do you authorize the release of information in your admission file to the parent/guardian named in F-13b?  Yes  No

UW Seattle Freshman Application  A3

 Family Information  (F) CONTINUED
F-25. Income and Household Size. Providing this information will not disadvantage you. Dependent students should complete F-25a.
Independent students should complete F-25b. (Providing this information is optional but encouraged.)

F-25a. Dependent Students Only Parents’/Guardians' Gross Annual Income. Family Size. Include parents/guardians, yourself,
(Estimate for current year if necessary.) and other dependents.

Most recent year completed _____________ $ ____________________.00 __________

Previous year _____________ $ ____________________.00 __________

F-25b. Independent Students Only Student’s Gross Annual Income. (Estimate for current year Student Family Size. Include yourself, spouse, and other dependents.
if necessary. If married, include your spouse’s income.)

Most recent year completed _____________ $ ____________________.00 __________

Previous year _____________ $ ____________________.00 __________

Schools & Colleges Attended  (SC)

Schools Attended Outside the U.S.

SC-1. Have you ever attended school outside the U.S.?   No: skip the rest of SC-1.   Yes: go on to the next question.
Mark an X next to EACH grade you have attended outside the U.S.   __ 1   __ 2  __ 3  __ 4  __ 5  __ 6  __ 7  __ 8   __ 9   __ 10   __ 11   __ 12

List all schools you attended outside the U.S. beginning with Grade 1.
NAME OF SCHOOL LOCATION GRADE LEVEL(S) CALENDAR YEAR LANGUAGE OF

example: E.G. 2005-06 INSTRUCTION

West Island School Hong Kong 9-12 2006 - 2010 Mandarin

SC-3. High School Graduation

Have you graduated — or will you graduate — from high school (not GED)?   Yes: mm/yyyy of Graduation    No: Highest grade level completed 

SC-4 Homeschool 
Have you ever participated in a homeschool program?   No   Yes: select all that apply: Grade(s)   9   10   11   12

SC-5. High School / Secondary Schools Attended 

List all high schools and secondary schools you have ever attended, are currently attending, or will attend before enrolling at the UW. Do not exclude or omit any,
regardless of how many credits you earn(ed) there or the nature of the program in which you were/are enrolled. Failure to disclose all schools may result in denial of
admission to the University.
NAME OF HIGH SCHOOL, COLLEGE, DATES OF ATTENDANCE (MO/YR) IF GRADE 9-12,
CEEB CODE LOCATION (CITY, STATE; COUNTRY IF OTHER THAN U.S.)
UNIVERSITY, ETC. FROM      TO SPECIFY GRADE LEVEL(S)

Last High School Attended

Other HIgh School(s) Attended (in reverse order of attendance)

SC-6. Colleges/Universities Attended 

List all colleges and universities you have ever attended, are currently attending, or will attend before enrolling at the UW. Include colleges attended while also enrolled
in high school programs such as Running Start, college in the high school, etc. Do not exclude or omit any institutions, regardless of how many credits you earn(ed)
there or the nature of the program in which you were/are enrolled. Failure to disclose all colleges and universities may result in denial of admission to the University.
NAME OF HIGH SCHOOL, COLLEGE, DATES OF ATTENDANCE (MO/YR) IF GRADE 9-12,
CEEB CODE LOCATION (CITY, STATE; COUNTRY IF OTHER THAN U.S.)
UNIVERSITY, ETC. FROM      TO SPECIFY GRADE LEVEL(S)

Last College Attended

Other College(s) Attended (in reverse order of attendance)

UW Seattle Freshman Application  A4

 College Courses  (CC-F) 
This section will ask you about the college courses (exclude AP and IB) you have completed or currently taking. List the details of each course in the appropriate section.

CC-F1. College Courses Completed  List all college courses completed to this point.
PREFIX & GRADE IN
COLLEGE TERM TYPE TERM/YEAR SHORT TITLE (20 Character limit) CREDITS
NUMBER COURSE

ex: Bellevue College  QTR   SEM Aut 2010 Art 101 Art Intro 5 B
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM

CC-F2. College Courses In Progress  It is very important that you list all college courses you are taking or planning to take before enrolling at the UW.
If your schedule is not final yet, please do not hesitate to complete this section. Just give us your best estimate about the courses you anticipate taking, with
specific titles. You can update your schedule later by email or postal mail.
PREFIX & GRADE IN
COLLEGE TERM TYPE TERM/YEAR SHORT TITLE (20 Character limit) CREDITS
NUMBER COURSE
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM
 QTR   SEM

CC-F3. College Grade-Point Average (GPA)

In the box below, enter your college grade point average. This figure should be the cumulative GPA for all coursework recorded on your college transcript.
If you attended more than one college, list the GPA from the college where you earned the most credit.

College GPA (x.xx) (as recorded on your college transcript)

Advanced Level Credit  (AL)

AL-1. Have you already earned — or do you expect to earn — any advance-level credit (e.g., A-level, STMP, HKALE, Arbitur, etc.,) before enrolling at the University of
Washington? Do not include AP or IB credit. 
 No   Yes: Please specify Certificate, Diploma, or Advanced Credit and date.
NAME OF SCHOOL CERTIFICATE/DIPLOMA/ADVANCED CREDIT DATE AWARDED OR EXPECTED  (mm/yyyy)

ex: Singapore American School A-Level 05/2010



Degrees Earned or Expected  (DG)

DG-1. Have you already earned — or do you expect to earn — an associate or bachelor’s degree before entering the University of Washington? 
 No   Yes: specify degree and date expected.
COLLEGE NAME OF DEGREE DATE OF DEGREE EARNED OR EXPECTED

ex: Yakima Valley CC Associate of Arts & Sciences June 2011




UW Seattle Freshman Application  A5
 College Academic Distribution Requirements (CADR) (CDR) — INSTRUCTIONS
CDR- Coursework must be completed by ALL applicants. Before proceeding, carefully read the full application instructions and
1,2. review the sample College Academic Distribution Requirements table (page A7) to make sure that you complete each
section correctly. In addition, carefully follow the instructions embedded within this section. You are accountable for
providing complete and accurate information. Omissions or inaccurate information may result in the denial of admission.

KEY TO COURSE NOTATIONS, CREDITS, AND GRADES

Course Notations Credit Grade in Course

Below are the symbols you should use in the
Course Notation column.
H Honors
AP Advanced Placement
IB International Baccalaureate
RST Running Start Program
(Washington State only)
CHS College in the High School
Coll College enrollment other than
RST or CHS
Home Homeschool
Use this key for the HS Credit column below.
Credit should be listed in high–school credits,
not college credits. Usually:
.5 credit = 1 semester
(see grades 10 and 12 on sample grid)
.33 credit = 1 high school trimester
(see grade 9 on sample grid)
1 credit = 1 full high school year, commonly
used in block system. Also, 5
quarter credits of college courses
(see grade 11 on sample grid)
Key to the Grade in Course column.
A=4, B=3, C=2, D=1, F=0.
These are the most common letter and/or
numerical grades used in the U.S. If your school
uses a different scale (e.g., a range of 100 –
65), indicate the actual grade recorded on your
transcript in this column.
NOTE: In CS-2, you will be asked to provide a
converted (4-pt scale) cumulative, unweighted GPA.

You must use the CADR tables to record all the courses you have taken, are
currently taking, or will be taking during your high school years of study.
Include all the courses you believe satisfy the CADR identified under each
subject heading. To review the requirements, go to
admit.uw.edu/Requirements/Freshman/CADR.
Before completing the application, collect personal copies of all your
transcripts from high school and (if college credit was already earned)
college. Use these copies as a guide to report your coursework accurately and
completely, using the actual course prefixes, titles, credits, etc. that appear
on your transcripts.
For help in understanding these instructions, use the Sample on page A7. It
illustrates most of the information you will enter in the table.
Grades 7 & 8
This section of the table is provided to help us understand more clearly the
levels of math and foreign language you have attained. Use this section only
if you completed high school-level math or foreign language in grades 7 and
8. In the other subjects, coursework in grades
7 and 8 is not considered.
Grades 9 through 11
Starting with the left column, mark the type of term (e.g., semester, etc.)
used at the school attended during each year of study, as well as the
dates of attendance (e.g., Begin: 2006, End: 2007) for each grade (9–11)
completed.
Grade in Course
List only actual grades you have earned in courses that you have
completed. Do NOT list mid-term grades you expect to earn in courses
that you are still taking or for which you have not yet received a grade
report or transcript.
Grade 12.
A complete listing of courses—completed, anticipated, and currently
in progress—in grade 12 is required. Use the same terms and course
notations you used for grades 9-11. You must list courses for your ENTIRE
final year of high school, not just the first term, and you must include
credits for each course. If your schedule is not final yet, include to the
best of your ability the courses you anticipate taking, with specific
titles; you can update your schedule later by email or postal mail. Your
application will not be processed if this section is incomplete.
College courses
Include here and in CC-1 on page A-5 any college courses in which you
are enrolled or plan to enroll.
CDR-3. Unweighted Grade-Point Average (GPA)
List your cumulative GPA for all courses completed during grades 9–11.
If you attended more than one school, this should be a combined GPA.
This figure should be taken from the unweighted GPA recorded on your
high school transcript. In an unweighted system, the quality points for
letter grades are assigned as A = 4, B = 3, C = 2, D = 1, F = 0.

Proceeding to the right, indicate the course title, including the course If your school uses a different scale (e.g., 100-point), consult with your
prefix and course number (if there is one), as well as any applicable course counselor about how to convert it to a comparable GPA on a 4-point scale.
notations (e.g., AP, IB, RST), the credit earned (e.g., .5) for each term of
coursework completed, and the grade (e.g., A, B, etc.) earned for each term
of coursework completed within each subject area. Be sure to also include
any Running Start courses already completed by the end of grade 11.
NOTE: If you are completing high school early (e.g., three years instead of
four), complete grades 9 and 10 as the first two years of study, and write “no
grade 11” in the first column of the grade 11 section. Use grade 12 to record
your final year of courses completed, anticipated, or currently in progress.

UW Seattle Freshman Application  A6

 Sample of College Academic Distribution Requirements — SAMPLE TABLE

Juana B. Admitted
Name of Applicant

GRADE IN COURSE

GRADE IN COURSE

GRADE IN COURSE

GRADE IN COURSE
COURSE NOTATION

COURSE NOTATION

COURSE NOTATION

COURSE NOTATION
ENGLISH MATH LAB SCIENCE SOCIAL SCIENCE

HS CREDITS

HS CREDITS

HS CREDITS

HS CREDITS
COUR SE T ITLE COUR SE T ITLE COUR SE T ITLE COUR SE T ITLE
GRADE IN SCHOOL

7+8 DO NOT WRITE IN THIS SECTION DO NOT WRITE IN THIS SECTION DO NOT WRITE IN THIS SECTION

9 English 9 .34 A Geometry I .34 B Int Phy Sci .34 B Amer. Gov’t .34 A
06 07 English 9 .33 B Geometry I .33 B Int Phy Sci .33 B Amer. Gov’t .33 A
YR BEGIN YR END

CHECK TERM T YPE

● Semester
English 9 .33 C Geometry I .33 B Int Phy Sci .33 B+ Amer. Gov’t .33 A-
● Trimester
● Block
● Other
● Summer

10 English 10 .5 B- Alg II .5 A Biology .5 B+ U.S. Hist .5 B+

07 08
YR BEGIN YR END English 10 .5 B+ Alg II .5 A Biology .5 A- U.S. Hist .5 A-
CHECK TERM T YPE
Geography .5 A-
● Semester
● Trimester
● Block
● Other
● Summer

11 English 11 1 B+ Trig/Anal 1 A Physics RST 1 A World Hist AP 1 A

08 09
YR BEGIN YR END Amer. Lit. H 1 A Precalculus H 1 A
CHECK TERM T YPE
● Semester
● Trimester
● Block
● Other
● Summer

12 AP English AP .5 AP Calculus AP .5 IB Biology IB .5 Psychology CHS 1

09 10
1ST TERM

YR BEGIN YR END

CHECK TERM T YPE

● Semester
● Trimester AP English AP .5 AP Calculus AP .5 IB Biology IB .5
2ND TERM

● Block
● Other
ADD'L TERMS

● Summer

CDR-3. Unweighted
CS-2. Unweighted Grade-Point
Grade-Point Average
Average (GPA)(GPA) In the  boxes
In theatboxes at right
right enter yourenter your
GPA for GPA 9for
grades grades11.9 through 11.
through
f This figure should be a cumulative, unweighted GPA as recorded on your high school transcript.
f This figure=should bewith
a cumulative, unweighted
more thanGPA as recorded on your high school transcript.

3 6 0
Unweighted 4.0 scale, no grade given 4 points.
Unweighted
f Carry the figure=out
4.0two
scale, with
places, no3.67.
e.g., gradeDogiven moreup
not round than 4 points.
or down.
ff California
California applicants:
applicants: Use Use the unweighted
the unweighted cumulative
cumulative GPA, notGPA, notorthe
the UC CSUUC or CSU GPA.
GPA.
f If your school uses a different scale (e.g., 100-point), talk to your counselor before you fill in these blanks.
UW Seattle Freshman Application A8

UW Seattle Freshman Application  A7

 College Academic Distribution Requirements (CDR) — PART I

Name of Applicant

GRADE IN COURSE

GRADE IN COURSE

GRADE IN COURSE

GRADE IN COURSE
COURSE NOTATION

COURSE NOTATION

COURSE NOTATION

COURSE NOTATION
ENGLISH MATH LAB SCIENCE SOCIAL SCIENCE

HS CREDITS

HS CREDITS

HS CREDITS

HS CREDITS
COURSE T ITLE COUR SE T ITLE COUR SE T ITLE COUR SE T ITLE
GRADE IN SCHOOL

7 + 8 DO NOT WRITE IN THIS SECTION DO NOT WRITE IN THIS SECTION DO NOT WRITE IN THIS SECTION

9
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

10
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

11
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

12
1ST TERM

YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
2ND TERM

 Block
 Other

ADD'L TERMS

 Summer

UW Seattle Freshman Application  A8

 College Academic Distribution Requirements (CADR)  — PART II

Name of Applicant

GRADE IN COURSE

GRADE IN COURSE

GRADE IN COURSE
COURSE NOTATION

COURSE NOTATION

COURSE NOTATION
FOREIGN FINE, VISUAL, OR OTHER SUBJECTS

HS CREDITS

HS CREDITS

HS CREDITS
LANGUAGE PERFORMING ARTS
COUR SE T ITLE
GRADE IN SCHOOL COURSE T ITLE COUR SE T ITLE

7 + 8 DO NOT WRITE IN THIS SECTION DO NOT WRITE IN THIS SECTION

9
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

10
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

11
YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
 Block
 Other
 Summer

12
1ST TERM

YR BEGIN YR END

CHECK TERM T YPE

 Semester
 Trimester
2ND TERM

 Block
 Other

ADD'L TERMS

 Summer

CDR-3. Unweighted Grade-Point Average (GPA)   In the boxes at right enter your GPA for grades 9 through 11.
f This figure should be a cumulative, unweighted GPA as recorded on your high school transcript.
Unweighted = 4.0 scale, with no grade given more than 4 points.
f  California applicants: Use the unweighted cumulative GPA, not the UC or CSU GPA.

UW Seattle Freshman Application  A9

 Admission Tests  (AT)
Admission Tests. You are required to have official test scores sent directly from the testing agency by the application deadline; official test scores are
received electronically. Scores coming from a source other than the testing agency, e.g., your high school, are not acceptable and will not be considered.
Only report the best overall score from a single sitting (test date).
NOTE: If your Social Security Number (SSN) is not included on your ACT with Writing or SAT report, the scores may not automatically match to your UW application
record and it will take longer to manually match your scores with your application record.

AT-1. Check the box(es) of the tests you've taken or plan to take, then answer the follow-up questions for each test.

  SAT Reasoning Test

Have you already taken this test?  Yes: Go to DATE TAKEN 

 No: Go to DATE TO BE TAKEN

DATE TAKEN (mm/yyyy)           

­­ DATE TO BE TAKEN (mm/yyyy)           
­­

Will your test report include your SSN?  Yes  No Will your test report include your SSN?  Yes  No

Scores sent to UW?  Yes Write here your name exactly as it will appear on this test:

Scores Verbal or Critical Reading  Last (Family Name)

Math 
First (Given Name) Middle (if any)
Writing

Write here your name exactly as it appears on this test:

Last (Family Name)

First (Given Name) Middle (if any)

 Check this box if your name on this test appears exactly

the same as the name on this application.

  ACT with Writing

Have you already taken this test?  Yes: Go to DATE TAKEN 

 No: Go to DATE TO BE TAKEN

DATE TAKEN (mm/yyyy)           

­­ DATE TO BE TAKEN (mm/yyyy)           
­­

Will your test report include your SSN?  Yes  No Will your test report include your SSN?  Yes  No

Scores sent to UW?  Yes Write here your name exactly as it will appear on this test:

Composite Score  
Last (Family Name)
Write here your name exactly as it appears on this test:
First (Given Name) Middle (if any)

Last (Family Name)

First (Given Name) Middle (if any)

 Check this box if your name on this test appears exactly

the same as the name on this application.

UW Seattle Freshman Application  A10

 Writing Section – Additional Comments (OPTIONAL)

WS-D. Is there anything else you would like us to know about you? Use this section for anything you wish to express that doesn't seem to fit in any of the required
Writing Section areas. For example, if you have experienced personal hardships in attaining your education, if your activities have been limited because of
work or family obligations, or if you want us to know how important a personal or professional goal is to you, tell us here.

Additional Information (AI)

AI-1. Use this space if you need to explain or clarify any answers you have given in this application or to provide additional information that may assist the
Admission Office. Be sure to include the question number to which your comment refers. Please do NOT use this space to write or add to your Writing Section.

Checklist (CL)
CL-1. Checklist
I understand that a complete application, which includes the following materials, must be submitted by the application deadline:
 Application
 Writing Section
 $60 Nonrefundable application fee
 Official test scores from ACT with Writing or SAT Reasoning Test, sent electronically from the testing agency.
 Transcripts: DO NOT SEND unless you receive a request from the Office of Admissions.
The application asks you to tell us about your academic coursework.
 Letters of Recommendation: DO NOT SEND.

Signature (SS)
SS-1. In signing this form, I certify that the statements I have made in this application are complete and true to the best of my knowledge. ​
I acknowledge that it is my responsibility to be aware of all pertinent admission and application requirements and that I have read and
understand the application instructions. I acknowledge that failure to disclose complete and accurate information, or failure to submit all
required application information — including those outlined in the Checklist CL-1 — may result in the denial of admission or subsequent
dismissal from the University of Washington.

I understand that my complete application must be signed and submitted by the application deadline to be considered for admission.

Signature of Applicant ____________________________________________________________________   Date ___________________

2020966 / 09.30.10 UW Seattle Freshman Application  A11

 Statistical Information  (ST)

APPLICANT'S NAME DATE OF BIRTH   mm  dd  yyyy

The University is required by the U.S. Department of Education to ask you about your ethnic identity.
The information you provide also allows the University of Washington to do the following:
1)  We can report aggregate demographic data to state and federal agencies as required by law.
2)  We can monitor the effectiveness of our recruitment and outreach efforts.
3)  The information may assist in the awarding of privately funded diversity scholarships.

This information will be separated from your application file and will not be used in the admission review process.

ST-1. Are you of Hispanic or Latino origin? (Check all that apply.)
 No 999
 Yes, In addition, select from the following:
 Mexican or Mexican American or Chicano 722  Peruvian 726  Other Hispanic or Latino:  739
(Specify, e.g., Ecuadoran, etc.)
 Argentinian 700  Puerto Rican 727
 Chilean 706  Salvadoran 712
 Colombian 707  Spanish/Spaniard 730
 Cuban 709  Hispanic 717

ST-2. Additionally, what race(s) do you consider yourself? Regardless of your answer to the previous question,
please mark the following box(es) to indicate what you consider yourself to be.
 African American or Black 870
 Alaska Native or American Indian 599
If possible, please specify tribal or corporate affiliation (e.g., Shoshone)

Verification of tribal or corporate affiliation is recommended.

UW departments and programs are encouraged to consider tribal or corporate enrollment or affiliation as a positive factor in admission,
financial aid, and outreach programs. Verification of affiliation — which is required in order to benefit — consists of one of the following:
Verification of tribal affiliation, which is required in order to benefit, consists of one of the following:
f Official tribal identification. Examples: copy of a Tribal Enrollment card, treaty fishing card, corporation papers,
or Bureau of Indian Affair (BIA) document.
f Certificate of membership verification by the BIA, a tribal enrollment official, community official or proof of direct descendancy.
 Asian American. In addition, select from the following:
 Asian Indian 600  Laotian 613  Other Asian American: 986
(Specify, e.g., Mongolian, etc.)
 Bangladeshi 601  Malaysian 614
 Cambodian 604  Pakistani 616
 Chinese 605  Singaporean 637
 Filipino 608  Sri Lankan 617
 Hmong 609  Taiwanese 606
 Indonesian 610  Thai 618
 Japanese 611  Vietnamese 619
 Korean 612  Asian American 621

 Caucasian or White 800

 Pacific Islander. In addition, select from the following:

 Fijian 676  Native Hawaiian 653  Other Pacific Islander: 985

Specify, e.g., Palauan, etc.
 Guamanian or Chamorro 660  Samoan 655
 Marian Islander 661  Tongan 657
 Melanesian 677  Pacific Islander 681
 Micronesian 669

UW Seattle Freshman Application  A12