Four-Year Pledge Application Form

Student Information

* First Name
Middle Initial
* Last Name
* Bronco ID
** Undeclared majors are not qualified to apply to the program **
* Major	Please Select One Accounting Aerospace Engineering Agricultural Biology Agricultural Science Agronomy Animal Science Anthropology Apparel Merchandising and Management Architecture Art Behavioral Science Biology Biotechnology Botany Business Administration Chemical Engineering Chemistry Civil Engineering Communication Computer Engineering Computer Information Systems Computer Science Construction Engineering Technology eBusiness Economics Electrical Engineering Electronics and Computer Engineering Technology Engineering Technology English Finance, Real Estate, and Law Food Marketing and Agribusiness Management Food Science and Technology Foods and Nutrition Gender, Ethnicity, and Multicultural Studies Geography Geology Graphic Design History Horticulture Hotel and Restaurant Management Industrial Engineering International Business Kinesiology Landscape Architecture Landscape Irrigation Science Liberal Studies Management and Human Resources Manufacturing Engineering Marketing Management Materials Engineering Mathematics Mechanical Engineering Microbiology Music Philosophy Physics Political Science Psychology Social Sciences Sociology Soil Science Spanish Technology and Operations Management Theatre Urban and Regional Planning Zoology
Telephone No.
* Cal Poly Email

SAT Information

Date Taken
SAT Math Score	(your highest score)
SAT Verbal Score	(your highest score)

ELM Information

Date Taken	(if taken)
ELM Score

EPT Information

EPT Score

(if taken)

MDPT Information

Math Analysis Total	(if taken)
PreCalculus Total	(if taken)
PreCalculus Trig Subscore	(if taken)

AP Test Information

AP Score(s)	-Test Name-	-Score Received-
1	Please Select One Calculus AB Calculus BC English Language & Composition English Literature & Composition Statistics	NA 1 2 3 4 5
2	Please Select One Calculus AB Calculus BC English Language & Composition English Literature & Composition Statistics	NA 1 2 3 4 5
3	Please Select One Calculus AB Calculus BC English Language & Composition English Literature & Composition Statistics	NA 1 2 3 4 5

Other Test Information

** Please list Test Name & Score **
Other Tests Taken (ACT, SAT II)

Course Information

** Students in Preparatory (Prep) English Classes are not eligible for the program **
Planned English Courses for Fall 2008	Please Select One Advanced Placement Credit Community College Credit (Please list course below) ENG 095 Basic Communication Skills I (Prep) ENG 096 Basic Communication Skills II (Prep) ENG 098 Basic Skills for ESL (Prep) ENG 099 Basic Grammar and Writing for ESL (Prep) ENG 102 College Composition for ESL ENG 104 Freshman English ENG 105 Freshman English II IGE 120 Consciousness and Community
** Students in Preparatory (Prep) Math Classes are not eligible for the program **
Planned Math Courses for Fall 2008	Please Select One Advanced Placement Credit Community College Credit (Please list course below) MAT 010 Prealgebra (Prep) MAT 011 Basic Algebra (Prep) MAT 012 Intermediate Algebra (Prep) MAT 105 College Algebra MAT 106 Trigonometry MAT 114 Analytic Geometry and Calculus I MAT 115 Analytic Geometry and Calculus II MAT 116 Analytic Geometry and Calculus III MAT 120 Calculus for the Life Sciences MAT 125 Introductory Calculus for Business MAT 130 Technical Calculus MAT 137 Survey of Geometry MAT 191 Survey of Mathematics STA 120 Statistics with Applications
Community College Math or English Courses
No. of Units registered for Fall 2008