also available online at admit.uw.edu/admission/freshmen/apply

2015-16 application for freshman admission & scholarships also available online at admit.uw.edu/admission/freshmen/apply Wherever you see this icon, find instructions in Part D of the accompanying instructions for freshman applicants. You are accountable for providing complete and accurate information. Omissions or inaccurate information may result in the denial of admission. Classification (C) C-1. C-2. C-3. Type: First-time Freshman Have you ever been or do you expect to be a Running Start participant (Washington State only)? Yes No Have you ever been or do you expect to be a participant in College in the High School or other college enrollment program? Yes No Q-1. Quarter (Q) Quarter. For which quarter and year are you applying? Check one box only SUMMER 2015 (begins June 2015) AUTUMN 2015 (begins September 2015) WINTER 2016 (begins January 2016 ) Deadline: Dec. 1, 2014 Deadline: Dec. 1, 2014 Deadline: Sept. 1, 2015 Major or Area of Interest (MJ) MJ-1. Major. What is your intended major or area of interest? (If undecided, choose one of the pre-majors options.) Major code MJ-2. Optional. Another Area of Interest. If you have another 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 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. Sex/Gender. Male Female PI-2. Social Security Number PI-3. Date of Birth (mm) (dd) (yyyy) 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 Campus Freshman Application A1

OFFICE USE ONLY Address (AD) AD-1. Mailing Address Number and Street 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 City State (Province/Territory + Country if not U.S.) Zip+4 (or Postal Code if not U.S.) AD-3a. Home telephone (U.S. phone numbers only) AD-3b. Cell phone (U.S. phone numbers only) AD-4. Email This must be a valid address that you check regularly. If it changes, notify Admissions promptly. Citizenship & Residency (CR) CR-1. Birthplace City and State CR-2. Are you a U.S. citizen? Yes: skip the next three questions. Country if other than U.S. No: go on to the next question. CR-3. What is your country of citizenship? CR-4. What is your country of permanent residence? Specify country Specify country CR-5. Current or Expected Visa Type or Immigration Status U.S. Permanent Resident/Immigrant Visa: Registration Number: A# Refugee Political Asylee International Student: visa types F, J or B, H, L, M, R, TD, TN Date issued/to be issued (mm) (yyyy) This is the wrong application. You need to complete the international application, available online at admit.uw.edu/admission/international/apply, or contact the Office of Admissions at admit.uw.edu/contact. 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) : 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) UW Seattle Campus 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 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 : 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 : 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. F-9. 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 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 : 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 : 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. F-21. 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 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 Campus Freshman Application A3

Family Information (F) CONTINUED F-25. Income and Household Size. Were you a Dependent or Independent Student for the 2013 tax year (or most recent year completed)? (Optional) Dependent Student Include income earned by your custodial parents/legal guardians, and include the number of dependents they claimed for tax purposes. Independent Student Include your income and, if married, your spouse s income. Do not include as income any student financial aid you received in the form of grants, loans or scholarships. F-25a. Dependent Students Only YEAR PARENTS GROSS ANNUAL INCOME PARENT FAMILY SIZE Most recent year completed $.00 Previous year $.00 F-25b. Independent Students Only YEAR STUDENTS GROSS ANNUAL INCOME STUDENT FAMILY SIZE Most recent year completed $.00 Previous year $.00 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. Are you a veteran of U.S. Military Service, on active military duty, or a member of the National Guard; OR are you the spouse or child of a U.S. military veteran or active duty service member? Yes No If yes, select the option that will best describe your status upon enrolling at the UW: I am a discharged veteran no longer serving on active duty or in the Reserve or National Guard. I am on active duty. I am a member of the National Guard. I am a Reservist, not including ROTC. I am the child or spouse of a U.S. military veteran or active duty service member. SP-3. Have you been in foster care in Washington State for at least one year since your 16th birthday? Yes No UW Seattle Campus Freshman Application A4

Schools & Colleges Attended (SC) SC-1. Schools Attended Outside the U.S. Have you ever attended school outside the U.S.? No: skip the rest of SC-1. Yes: complete the other questions in SC-1. 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 13 14 15 16 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. 2008-09 INSTRUCTION West Island School Hong Kong 9-12 2011-15 Mandarin SC-3. SC-4. SC-5. 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 Homeschool Have you ever participated in a homeschool program? No Yes: select all that apply: Grade(s) 9 10 11 12 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 UW. CEEB CODE NAME OF HIGH SCHOOL OR SECONDARY SCHOOL LOCATION (CITY, STATE; COUNTRY IF OTHER THAN U.S.) DATES OF ATTENDANCE (MM/YYYY) FROM TO IF GRADE 9-12, 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 UW. Attach an additional page if necessary.yy CEEB CODE NAME OF COLLEGE, UNIVERSITY, ETC. LOCATION (CITY, STATE; COUNTRY IF OTHER THAN U.S.) DATES OF ATTENDANCE (MM/YYYY) FROM TO Last College Attended Other College(s) Attended (in reverse order of attendance) UW Seattle Campus Freshman Application A5

College Courses (CC-F) This section will ask you about the college courses (exclude AP and IB) you have completed or are currently taking. List the details of each course in the appropriate section. CC-F1. College Courses Completed List all college courses completed to date. Even if you also list them in HSC-1, HSC-2, High School Coursework, please list them again here. COLLEGE TERM TYPE TERM/YEAR PREFIX & NUMBER SHORT TITLE (20 Character limit) ex: Bellevue College Aut 2014 Art 101 Art Intro 5 B CREDITS GRADE IN COURSE CC-F2. College Grade-Point Average (GPA) Enter your college grade point average at right. This figure should be the cumulative GPA for all coursework, as 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) CC-F3. 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. COLLEGE TERM TYPE TERM/YEAR PREFIX & NUMBER SHORT TITLE (20-character limit) CREDITS GRADE IN COURSE Advanced Level Credit (AL) AL-1. Do you expect to earn an International Baccalaureate (IB) diploma? No Yes AL-2. 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 05/2014 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: Shoreline CC Associate in Science - Transfer June 2015 UW Seattle Campus Freshman Application A6

High School Coursework (HSC) PART I Name of Applicant GRADE IN SCHOOL ENGLISH MATH LAB SCIENCE WORLD LANGUAGES 7 + 8 9 10 11 12 ADD'L TERMS 2ND TERM 1ST TERM TOTAL YEARS Gr 9-11 Gr 9-11 Gr 9-11 Gr 9-11 Gr 12 Gr 12 Gr 12 Gr 12 Highest Math Level: Name of World Language: Highest Level: UW Seattle Campus Freshman Application A7

High School Coursework + HS GPA (HSC) PART II Name of Applicant GRADE IN SCHOOL 7 + 8 SOCIAL STUDIES/ SOCIAL SCIENCE FINE, VISUAL, OR PERFORMING ARTS OTHER SUBJECTS HSC-3. Unweighted Grade-Point Average (GPA) In the boxes beneath, enter your GPA for grades 9 through 11. 9 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. 10 11 12 ADD'L TERMS 2ND TERM 1ST TERM TOTAL YEARS Gr 9-11 Gr 9-11 Gr 9-11 Gr 12 Gr 12 Gr 12 UW Seattle Campus Freshman Application A8

Admission Tests (AT) Admission Tests. You are required to have all official test scores sent directly from the testing agency. Official test scores are received electronically. Scores coming from a source other than the testing agency, such as your high school, are not acceptable and will not be accepted. For the self-reported information requested below, record the scores for each test date. Deadline: Test scores must arrive no later than December 31, 2014. Go to admit.uw.edu/admission/freshmen/testscores for complete, detailed information about reporting and submitting test scores. 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 OR RE-TAKEN SAT Scores DATE TAKEN (MM/YYYY) Verbal or Critical Reading Math Writing DATE TO BE TAKEN OR RE-TAKEN (mm) (yyyy) Write your name exactly as it appears on SAT test reports: Last (Family Name) First (Given Name) Middle (if any) ACT with Writing Have you already taken this test? Yes: Go to DATE TAKEN No: Go to DATE TO BE TAKEN OR RETAKEN ACT Scores DATE TAKEN (MM/YYYY) Composite English Mathematics Reading Science Writing DATE TO BE TAKEN OR RE-TAKEN (mm) (yyyy) Write your name exactly as it appears on ACT test reports: Last (Family Name) First (Given Name) Middle (if any) UW Seattle Campus Freshman Application A9

Criminal History (CH) By signing this application (Question SS-1), you agree to immediately notify the Office of Admissions should there be a change of circumstances that affects the accuracy of your answer to CH-1 between the date you submit your application and your first day of classes. CH-1. Have you ever been convicted of or adjudicated to be guilty of a violent felony offense, required to register as a sex offender by any legal authority in the U.S. or any other country, or are any charges involving a violent felony or sex offense pending against you at this time? No Yes If you answered yes, go on to question CH-2. CH-2. List all the offenses and/or pending charges, the date of each offense/charge, and the date of each conviction/adjudication. Also, describe the circumstances surrounding each offense/charge and if you wish, you may provide a statement as to why you believe this information should not be a cause for concern about the safety of the university community. NOTE: The UW reserves the right to request additional information related to any of your criminal matters. Answers to these questions will be used primarily to decide what support students may need to succeed at the UW. Please let us know if there are any special arrangements or restrictions we need to know about in order to accommodate your attendance. Checklist (CL) CL-1. Checklist I understand that a complete application, which includes the following materials, must be submitted by the application deadline: f Application f Writing Section f $60 nonrefundable application fee f 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 and include in subsequent correspondence are/will be 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 all application instructions. I understand that failure to disclose complete and accurate information, or failure to submit all required application information and official documents including those outlined in the Checklist (CL-1) may result in the denial of admission, withdrawal of admission, subsequent dismissal from the University of Washington, or other corrective actions as necessary. I understand that my complete application must be signed and submitted by the application deadline to be considered for admission. Signature of Applicant Date 2066208 / 09.18.2014 UW Seattle Campus Freshman Application A10

Statistical Information (ST) APPLICANT'S NAME DATE OF BIRTH mm dd yyyy The University of Washington 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? No, I am not Hispanic in origin. Yes, I am Hispanic in origin. Check all that apply. Argentinian 700 Bolivian 701 Chilean 706 Colombian 707 Costa Rican 708 Cuban 709 Dominican 710 Ecuadorian 711 Guatemalan 716 Honduran 718 Mexican, Mexican American, Chicano 722 Nicaraguan 723 Panamanian 724 Peruvian 726 Puerto Rican 727 Salvadoran 712 Spanish 730 Uruguayan 734 Venezuelan 735 Hispanic Origin (Specify): 739 ST-2. How do you describe your race? Check all that apply. 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. Check all that apply. African American 870 Ethiopian 921 Kenyan 923 Somali 924 Eritrean 920 Ghanaian 922 Nigerian 912 African Origin (Specify:) 871 American Indian or Alaska Native. If possible, please specify tribal or corporate affiliation e.g., Chinook) NOTE: 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 the following: f Official tribal identification. Example: copy of a Tribal Enrollment card, treaty fishing card, corporation papers, or Bureau of Indian Affairs BIA) document. f Certificate of membership verification by the BIA, a tribal enrollment official, community official or proof of direct descendance. Asian. Check all that apply. Asian American 621 Chinese 605 Madagascar 639 Singaporean 637 Asian Indian 600 Filipino 608 Malayan 614 Sri Lankan 617 Bangladeshi 601 Hmong 609 Maldivian 634 Taiwanese 606 Bhutanese 602 Indonesian 610 Mien 647 Thai 618 Burmese 603 Japanese 611 Mongolian 624 Vietnamese 619 Cambodian 604 Korean 612 Nepali 635 Asian Origin (Specify:) 986 Cham 646 Laotian 613 Pakistani 616 Caucasian or White. 800 Includes people of European, Middle Eastern, or North African descent. Native Hawaiian or Other Native Pacific Islander. Check all that apply. Fijian 676 Native Hawaiian 653 Solomon Islander 679 Vanuatuan New Hebrides Islander 680 Guamanian 660 Pacific Islander 681 Tahitian 656 Yapese 675 Kosraean 667 Palauan 663 Tarawa Islander 672 Pacific Island Origin Specify: 695 Mariana Islander 661 Papua New Guinean 678 Tokelauan 659 Marshall Islander 662 Ponapean 670 Tongan 657 Micronesian 669 Samoan 655 Trukese Chuukese 674 UW Seattle Campus Freshman Application A11

2015 Writing Section Prompts and Instructions These are the 2015 Freshman Writing Section prompts. The Writing Section is a required and important part of your application for admission. A. Personal Statement (Required) The Personal Statement is our best means of getting to know you and your best means of creating a context for your academic performance. When you write your personal statement, tell us about those aspects of your life that are not apparent from your academic record. Tell us about the experiences that don t show up on your transcript: f A character-defining moment, f The cultural awareness you ve developed, f A challenge you ve faced, f A personal hardship or barrier you ve overcome. Directions Choose either A or B. Maximum length: 600 words. A. Discuss how your family s experience or cultural history enriched you or presented you with opportunities or challenges in pursuing your educational goals. B. Tell us a story from your life, describing an experience that either demonstrates your character or helped to shape it. Tips f Some of the best statements are written as personal stories. We welcome your imaginative interpretation. f You may define experience broadly. For example, in option B, experience could be a meeting with an influential person, a news story that spurred you to action, a family event, or something that might be insignificant to someone else that had particular meaning for you. If you don t think that any one experience shaped your character, don t worry. Simply choose an experience that tells us something about you. B. Short Response (Required) Directions Choose one of the following two topics and write a short essay. Maximum length: 300 words. 1. The University of Washington seeks to create a community of students richly diverse in cultural backgrounds, experiences, and viewpoints. How would you contribute to this community? 2. Describe an experience of cultural difference or insensitivity you have had or observed. What did you learn from it? Tip f You may define culture broadly in Topic #2. For example, it may include ethnicity, customs, values, and ideas, all of which contribute to experiences that students can share with others in college. As you reply to this question, reflect on what you have learned about yourself and society from an experience of cultural difference. C. Additional Information About Yourself or Your Circumstances (Optional) Directions Recommended length: Maximum length: 200 words. You are not required to write anything in this section, but feel free to include additional information if something has particular significance to you. For example, you may use this space if: f You are hoping to be placed in a specific major soon f A personal or professional goal is particularly important to you f You have experienced personal hardships in attaining your education f Your activities have been limited because of work or family obligations f Unusual limitations or opportunities unique to the schools you attended D. Additional Space (Optional) Directions You may use this space if you need to further explain or clarify answers you have given elsewhere in this application, or if you wish to share information that may assist the Office of Admissions. If appropriate, include the application question number to which your comment(s) refer. E. Activities & Achievements Directions Using the grid provided below, identify up to five of your most significant activities and achievements during grades 9-12. In a few bullets or sentences, indicate your contribution. Maximum length: 50 words for each activity. You may include activities, skills, achievements, or qualities from any of the following categories: f Leadership in or outside of school-e.g., athletics, student government, cultural clubs, band, scouting, community service, employment f Activities in which you have worked to better your school or community f Exceptional achievement in an academic field or artistic pursuit f Personal endeavors that enrich the mind-e.g., independent research or reading, private dance or music lessons, weekend language/culture school Format for the Writing Section f Content as well as spelling, grammar, and punctuation are considered. f If you re applying online, compose in a word processing program such as Word, then copy and paste into the windows provided. Double-spacing, italics, and other formatting will be lost, but this will not affect the evaluation of your application. We ve observed that most students write a polished formal essay for the Personal Statement yet submit a more casual Short Response and Journal of Activities & Achievements. Give every part of the Writing Section your very best effort, presenting yourself in standard, formal English. f Proffreed, proofreed, PROOFREAD! Tip f Write like it matters, not like you re texting. This is an application for college, not a message to your BFF. Writing i instead of I, cant for cannot, yr for you re: not so gr8. UW Seattle Campus Freshman Application A12