Get Connected to UCLA

Thank you for your interest in UCLA! Please complete this form so we can keep in touch about events we'll be hosting in your area and on campus.

* denotes a required field

About You

First Name *

Middle Name

Last Name *

Preferred First Name

Gender

Birthdate *

Contact Information

Email Address *

Re-Enter Email Address *

Mailing Address *

Country
Street
City
Region
Postal Code

Additional Information

Most Recent School Attended *

I plan to apply as a: *

Freshman

Transfer

I plan to enter UCLA in: *

I plan to study: (select one)

UCLA Undergraduate Admission

Get Connected to UCLA