California Student Application: University of California LanguageBird A-G Courses
This form is for California students who attend California high schools who have not applied to college (or are in the process currently) and will be applying to the University of California. The Regents, through the Department of Student Affairs will take the necessary steps to ensure student receive A-G credit for LanguageBird courses if this application is filled out and submitted by September 30, 2018.
Student Information
Student Full Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Student Email
*
Confirmation Email
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
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Japan
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Libya
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Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Mauritius
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Mexico
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Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
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Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
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Tunisia
Turkey
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Tuvalu
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United Arab Emirates
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Vanuatu
Vatican City
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British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Sex
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
High School
Required if student is in High School
High School Graduation Year
Required if student is in High School
Parent Information
Parent Full Name
First Name
Last Name
Parent Email
What year will the student apply to the UC?
What year will be their intended freshman year at the UC?
LanguageBird Course Information
What language did you take with LanguageBird?
*
French
German
Hebrew
Italian
Japanese
Mandarin
Spanish
Am. Sign Lang (ASL)
Arabic
Russian
Korean
Choose your language option from the dropdown menu.
What course/s would you like to submit to the UC for A-G credit?
Administration Fee
Program Type:
*
UC Submission
$
75.00
Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Year
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
Parent Signature
*
Required if student is under 18 years of age.
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