THE UNIVERSITY OF G E O R G IA

AP P L I CAT I O N F O R F I R S T -YEAR AD M I S S I O N PART I

Please attach a check or money order for the non-refundable application processing fee in the amount of $60.00 made payable to
“The University of Georgia.” Include applicant’s name and Social Security Number on check. Do not send cash. Please type or print
using a pen with dark ink. Fully complete all required sections. Return paper application with supporting credentials to the following
address: Office of Undergraduate Admissions; Terrell Hall; The University of Georgia; Athens, GA 30602-1633.

Social Security Number Date Of Birth / /

MONTH DAY YEAR

Full Name
LAST FIRST MIDDLE S U F F I X ( JR., III, E T C.)

Name Called Other last name on record

Mother's Maiden Name

1. Admission Categories and Address Information

Enter the semester (Spring, Summer, Fall) and year in which you intend to begin your enrollment at the University of Georgia.

Example: Fall 2014

Application type ( Read Definitions on previous page and check as applicable. )

First-Year Applicant ( Freshman ) Joint Enrollment Advanced Enrollment
Decision plan ( Available for First-Year Applicants, Summer and Fall semesters only; check one. )
Early Action ( Deadline - October 15 - Part I ) Regular Decision ( Deadline - January 15 - Parts I & II )

Current mailing address to which all admission correspondence should be mailed

NUMBER AND STREET, APARTMENT NUMBER, AND / OR P.O. BOX

CITY STATE / PROVINCE ZIP / POSTAL CODE

COUNTRY

Telephone number associated with current address

AREA CODE TELEPHONE NUMBER

Email address to which all e-correspondence should be sent

Parent email address

Note: Because we will use e-mail as our primary means of contacting you throughout the process, please provide us with an e-mail address which you check regularly
and update us immediately should this address change.

Permanent mailing address, if different from the current mailing address

NUMBER AND STREET, APARTMENT NUMBER, AND / OR P.O. BOX

CITY STATE / PROVINCE ZIP / POSTAL CODE

COUNTRY

Telephone number associated with permanent address

AREA CODE TELEPHONE NUMBER

You may also apply online at www.admissions.uga.edu I-1

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR
2. Optional Biographic Information
Colleges and universities are asked by many entities to describe the racial / ethnic backgrounds of our students and employees. In order to
respond to these requests, we ask you to please answer the following to optional questions.
Do you consider yourself to be Hispanic or Latino/a? Yes No
Regardless of your answer above, please select one or more of the following racial categories to describe yourself:

White (including Middle Eastern) Black or African American (including Africa and Caribbean)

American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Asian (including the Indian subcontinent)
Are you currently active duty military or a family member of someone who is active duty military? Yes No
Are you currently a member of the Georgia National Guard or a family member of someone who is a member of the Georgia
National Guard?
Yes No
Gender Male Female
Native Language English Spanish Other
( Required for international students who need a Form I-20 )

Birthplace
CITY / COUNTY / PARISH STATE / PROVINCE COUNTRY
( Required for international students who need a Form I-20 )
Father's name Mother's name

LAST, FIRST, MIDDLE, SUFFIX ( JR., III, ETC. ) LAST, FIRST, MIDDLE, SUFFIX ( JR., III, ETC. )

Father's birthplace Mother's birthplace

Father's highest level of education ( Check one. ) Mother's highest level of education ( Check one. )
Less than high school diploma High school diploma Less than high school diploma High school diploma
Technical school Some college Technical school Some college
Bachelor's degree Graduate degree Bachelor's degree Graduate degree
Father's occupation Mother's occupation
Employer Employer
Is father a UGA employee? Yes No Is mother a UGA employee? Yes No
If father is deceased, date of death If mother is deceased, date of death

With whom do you currently reside? Father Mother Both Other

In what city & state?
CITY / COUNTY / PARISH STATE / PROVINCE

Do you live in a single-parent home? Yes No Total number in household

Primary language spoken at home
Extraordinary family obligations
Required to work to supplement family income? Yes No Serve as primary caregiver for family member(s)? Yes No
Please describe

Indicate any immediate family members who have attended or are currently attending UGA.
Father Mother Sibling
List any members of your immediate family (only include parents, stepparents or siblings) who have attended or are currently attending UGA
Name Relationship Class Of
Name Relationship Class Of
Name Relationship Class Of
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Full Name
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Date Of Birth / /
MONTH DAY YEAR

Special Circumstances
If you have experienced any special circumstances that may have affected your academic achievement, please provide details to enable
appropriate consideration.

3. Required Biographic Information

Citizenship ( Check one. ) United States Other (Specify country of citizenship)

Permanent Resident ( Include a copy of Alien Registration Card to be used for residency and tuition purposes. )
If applicable, how many years have you lived in the United States?
If you currently reside in the U.S. but are not a U.S. citizen or Permanent Resident, what kind of visa do you hold?
Student (F-1/F-2) Exchange (J-1) Tourist (B-2) Refugee Other (Specify)
If you require a Form I-20 Certificate of Eligibility in order to obtain a student (F-1) visa to study in the United States legally, you must complete
the UGA Certificate of Finances form available on our Web site at www.admissions.uga.edu and submit it with the appropriate documentation
with your application for admission.
Residency In general, in-state residency for tuition purposes in the University System of Georgia requires full-time domicile and legal residency
in the state of Georgia for at least the twelve (12) consecutive months prior to your first enrollment. We will review all responses to assure that
students meet the residency policies set by the Board of Regents for the University System of Georgia. For a complete description of residency
regulations, visit http://www.usg.edu/student_affairs/faq/residency/
Do you claim to be a legal resident of Georgia for in-state tuition purposes? Yes No
If "No," in which state / country do you reside? (You may continue to Section 4)

If "Yes," in which Georgia county do you reside?

How long have you continuously resided in Georgia? /

YEARS MONTHS
Has the claiming individual (you if you claim to be independent, or your parents/legal guardians if you are a dependent), filed a
Georgia Income Tax return claiming Georgia Residency in the past year? Yes No
If "No," what is your legal state of residency?
4. Intended Major
Using the list provided in this packet (page iv), identify the course of study you wish to pursue at the University of Georgia. Enter the
appropriate school or college, intended major, and major code below. If applicable, please list your intended pre-professional program as well.
School / College
First Intended Major Code

Reason for choosing major

Second Intended Major Code

Reason for choosing major

Intended pre-professional program Code

5. Prior Educational Experience

List all vocational-technical schools, and colleges, starting with your current or most recent school, along with any diplomas or degrees earned.
Include colleges attended for courses taken while in high school. Complete disclosure is absolutely required. Failure to list all institutions
may result in rescission of admission, invalidation of credits or degrees earned, and/or disciplinary action.
High school (s) attended
ETS High School Complete High School Name City, State From (mo / yr) first To (mo / yr); expected Diploma earned, year
code (If known) attendance last attendance

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR

Are you currently enrolled in the first institution listed above? Yes No
If you are not entering college immediately following high school graduation, attach a separate sheet detailing what you have been doing since
high school. Please be sure to include your name and Social Security Number.
Do you plan to graduate from your current institution? Yes No If “Yes,” when?
College(s) attended
FICE college code Complete College Name City, State From (mo / yr) first To (mo / yr); expected Degree earned, year
(If known) attendance last attendance

Senior Coursework
Please list the courses you will complete this year, both current and upcoming high school and/or college classes, and the academic level of
the coursework (i.e., Honors, AP). Then list the course credit length , type of schedule (i.e., semester, quarter, block), and term in which the
courses are to be taken. Failure to complete this information will delay the processing and review of your application. Abbreviations are okay
(i.e., Fall - F, Spring - S).
Name of course / level Credit / term(s) Name of course / level Credit / term(s)

ex. Government Honors half-year credit/fall semester Calculus A.P. full-year credit/spring block

To be considered for first-year admission to the University of Georgia, high school students must have completed at a minimum the
following 16 units, as prescribed by the Board of Regents of the University System of Georgia: 4 years of English 4 years of Math
(including Algebra 1 and 2, geometry, and a fourth year beyond these three such as Adv. Alg. and Trig., Alg. 3, pre-calculus, etc.), 3 years of
science with at least one life sciences lab course and one physical sciences lab course, 3 years of social science, and 2 years of the same
foreign language. By the time of your high school graduation, will you have completed these required courses?
Yes No
In what foreign language have you completed 2 or more classes for high school credit (if you have completed 2 or more years in
multiple languages, please select the one you will have progressed the furthest in by graduation)?
Arabic Chinese French German Hebrew Italian Japanese Greek Latin
Portuguese Russian Spanish Other Not Taken

6. Standardized Testing History

In the following chart, please list the date and corresponding results, if available, for any SAT I and/or ACT, SAT II, Advanced Placement (AP)
and/or International Baccalaureate (IB), or TOEFL examinations which you have taken or for which you are registered. Note: Scores reported
here are unofficial and will be used only for informational purposes. With the exception of TOEFL, official test scores must be submitted to UGA
electronically by the respective testing agency. English (ACT)
Test Date Composite / Total Critical Reading (SAT) Math Writing

ex. ACT 6/10/07 28 28 30 26

7. Additional Required Information: You must answer all four questions.

Failure to answer these four questions properly will result in a delay in processing your application.
A) Have you previously applied for admission to UGA? Yes No
If "Yes," for what term and year? / Your last name then
TERM YEAR

B) Have you ever enrolled in UGA courses for credit, including independent study? Yes No
If "Yes," for what term and year? / Your last name then
TERM YEAR
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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR
If your answer to either of the following is yes, you must submit a full statement of relevant facts on a separate sheet to be attached to this form.
C) Are you currently, or have you ever been, charged with, or subject to, disciplinary action including suspension or expulsion for
scholastic or any other type of misconduct at any high school, college, or university? Yes No

D) Have you ever been charged with, convicted of, or pled guilty or nolo contendere to a crime other than a minor traffic offense, or
are any criminal charges now pending against you? Yes No
Convictions shall include: A finding of guilty by a judge or jury, a plea of guilty, or a plea of nolo contendere, a plea of no contest, an Alford Plea
to a criminal charge, or a plea under a first offender act, irrespective of the pendency or availability of any appeal or application for collateral
relief. If "Yes," explain fully, specifying the nature of the offense(s), the date(s) it/they occurred, the name and location of the court(s), and
sentence(s) imposed. Please have the appropriate authority submit official court documentation directly to UGA’s Office of Admissions.

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR

9. Leadership and Activity Record

Before completing this section, please identify the most appropriate subsection in which to place each of your activities, experiences or awards.
List each item only once. Confine all information on your co-curricular activities and awards to the space provided. Only that which you include
on your application form will be included in your admissions file. Please write legibly. Do not attach to or include with your application any
resumés, certificates, or additional letters of recommendation.
School and Community Activities
List your top five activities by their order of importance to you, with the most important activity first. For each one, explain what you did in the
activity. Describe the activity, your function, accomplishments, position held, and leadership demonstrated. Volunteer activities may be
included. Do not duplicate entries found in any other section. Do not include the following in this section: employment, sports, or summer
activities, since that information is considered elsewhere.
Does your school require that you complete community service hours? Yes No If Yes, how many a month

Activity Grade level Accomplishments and awards

Student government, societies, publications, fine Offices held, honors received. Please elaborate on your
arts, civic organizations, academic teams, JROTC, contribution.
organizations, band, etc. 9 10 11 12

Ex) Multicultural Club ✘ ✘ ✘ ✘ 9. Helped found club for students interested in issues and

experiences related to diversity. 10. Organized a successful Multicultural Fair. 12. Served as president, and organized tutoring program for
local Boys & Girls Club.

1)

2)

3)

4)

5)

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR
Athletics
Please mark: V for Varsity, JV for Junior Varsity, C for Community, or I for Intramural under each grade level as appropriate.
Sport 9 10 11 12 Description

Ex) Basketball JV JV JV JV 12. Co-captain, school record for assists 11. Winter Sports Player
of the Year 10. Winter Sports Spirit Award.

1)

2)

3)

4)

Honors and Awards

List below any significant honors or awards you have received and the year you were recognized.
Honors / Awards Won; Special Recognition 9 10 11 12 Description
Eagle Scout ✘ ✘ ✘ ✘
Ex) Highest rank in Scouting. Based on service, leadership and Ex.
outdoor activities.

1)

2)

3)

4)

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR
Work Experience
If you have had one or more jobs during any school year while in high school, please list up to three of them here by their order of
importance to you, with the most important job first. Work during summers should be listed under the summer activities section.
Employer Position, duties, accomplishments, leadership and supervisory roles, recognition, and benefits you derived. Dates Hrs / Week
9/05 - present 20
Ex) Burgerbasket - Crew chief and cashier 4-8p.m. shift. In charge of crew of seven for food prep and filling
orders.

1)

2)

3)

Summer Activities
Please describe your most significant activities (e.g., academic or leadership enrichment, volunteer programs, work) in each of the past three
summers. Do not duplicate entries in other sections. Cite the length of time spent in each activity. Describe personal accomplishments,
leadership roles, selectivity, and what benefits you received in each activity. You may include more than one significant activity per summer.
Employer Position, duties, accomplishments, leadership and supervisory roles, recognition, and benefits you derived.

Ex) Summer prior to 12 Burgerbasket - Crew chief and cashier 4-8p.m. shift. In charge of crew of seven for food prep and filling orders.
Awarded certificate for most efficient crew in South Georgia region. Received one of two Burgerbasket scholarships
awarded in state.

1) Summer prior to 10

2) Summer prior to 11

3) Summer prior to 12

Special Circumstances
If you have experienced any special circumstances, please provide details to enable appropriate consideration.

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Full Name
PART LAST FIRST

Date Of Birth / /
MONTH DAY YEAR

9. Self Reported GPA

As a freshman applicant, it is required that you complete the following Self-Reported Academic Record Chart. UGA will use this, along with the
required high school transcript, to review your high school academic performance. It is important that you complete this chart accurately and
completely, so we suggest you obtain a copy of your transcript before moving forward with completing this section. You must list all academic
grades, even if a course was repeated or taken during the summer. If you are admitted, we require that you send us a copy of your final high
school transcript, and we will check for both graduation and we will verify the grades you listed on the Self-Reported Academic Record Chart.
Any discrepancies may result in UGA rescinding your offer of admission.

If you attend an international school that does not follow the US grading system, or if you are a home-educated student attending a
non-accredited institution, please indicate so here. All other applicants MUST complete the Self-Reported Academic Record.

Yes, I can self report my GPA. No, I can NOT self report my GPA.

Courses A's B's C's D's F's

English

Math

Social Studies

Science

Foreign Language

Other AP / IB

Of the above grades, how many are AP/IB?

How many full year AP/IB classes will you have completed by the end of your senior year (round up if needed).

10. The University of Georgia Honor Code and Application Validation Statement
"I will be academically honest in all of my academic work and will not tolerate the academic dishonesty of others."

ALL applicants must read and sign the following section in order to complete the Application for Admission to the University of Georgia:

By my signature below, I understand that I am subscribing to the University of Georgia’s Honor Code and agreeing to be bound by such in the
event that I am admitted and subsequently enroll as a student at the University. I understand that, until I enroll, I have a continuing obligation to
update the information submitted to the University in my Application for Undergraduate Admission. I further attest that to the best of my
knowledge all of the information I have supplied in this application, or will subsequently submit, is complete and accurate and that any omission
or misrepresentation will invalidate any further consideration or subsequent admission.

Additionally, I understand and agree that I will be bound by the University's regulations concerning admission requirements, including all
application and enrollment deadlines. Finally, I understand that the $60.00 application processing fee is non-refundable, as is the $200.00
commitment deposit (due May 1 should I be admitted as a first-year student).

Applicant's Original Signature (in ink)

Social Security Number Signed / /

MONTH DAY YEAR

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 THE UNIVERSITY OF GEO RGIA
2 0 1 0 AP P LI CAT I O N F O R F I R S T -YEAR AD M I S S I O N PART II
Part II of the application for First-Year Admission is required of all Regular Decision, Deferred Early Action, and Joint or Advanced
Enrollment applicants. Please type or print using a pen with dark ink. Fully complete all required sections. Return paper application with
supporting credentials to the following address: Office of Undergraduate Admissions; Terrell Hall; The University of Georgia; Athens,
GA 30602-1633.

Social Security Number Date Of Birth / /

MONTH DAY YEAR

Full Name
LAST FIRST MIDDLE S U F F I X ( JR., III, E T C.)

Name Called Other last name on record

Mother's Maiden Name

Required for UGA's online Application Status Check

10. Short Essays

In the space provided or as a separate attachment labeled "UGA Short Essays," please address each of the following four topics in responses
of 150-200 words each. Prior to writing your short essays, we strongly encourage you to read the UGA Faculty Statement on Diversity, which is
available on our Web site at www.admissions.uga.edu. Please be sure to include your full name (as listed on your application) and date of birth
on each page of the attachment, as well as the essay topic with each of your responses.
A) Choose an intellectual or creative opportunity from your high school years that you have enjoyed and highlight how you have
grown personally because of the experience.

B) “Each friend represents a world in us, a world possibly not born until they arrive, and it is only by this meeting that a new world is
born.” - Anais Nin
From freshman year to now, we know that you have interacted with a number people in your high school who are different from you
and have affected who you are now. Tell us about one such relationship, with a focus on the details of your interaction, not the person.

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Full Name
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MONTH DAY YEAR

C) Tell us an interesting or amusing story about yourself that you have not already shared in your application.

D) “Music expresses that which cannot be put into words and cannot remain silent.” - Victor Hugo
If someone were to look at your music collection right now, they would probably know a great deal about who you are. Individuals
are drawn to music, and each song conveys something about that person. Select a musical piece to be your theme song. Tell us what it
would be, and more specifically, why it represents who you are.

11. The University of Georgia Honor Code and Application Validation Statement
"I will be academically honest in all of my academic work and will not tolerate the academic dishonesty of others."

ALL applicants must read and sign the following section in order to complete the Application for Admission to the University of Georgia:

By my signature below, I understand that I am subscribing to the University of Georgia’s Honor Code and agreeing to be bound by such in the
event that I am admitted and subsequently enroll as a student at the University. I understand that, until I enroll, I have a continuing obligation to
update the information submitted to the University in my Application for Undergraduate Admission. I further attest that to the best of my
knowledge all of the information I have supplied in this application, or will subsequently submit, is complete and accurate and that any omission
or misrepresentation will invalidate any further consideration or subsequent admission.

Additionally, I understand and agree that I will be bound by the University's regulations concerning admission requirements, including all
application and enrollment deadlines. Finally, I understand that the $60.00 application processing fee is non-refundable, as is the $200.00
commitment deposit (due May 1 should I be admitted as a first-year student).

Applicant's Original Signature (in ink)

Social Security Number Signed / /

MONTH DAY YEAR

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