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Graduation Pledge Four Year Application

Thank you for your interest in the Four Year Graduation Pledge. Please fill in as much information as you know.

The fields marked with an asterisk (*) in the Student Information section are required.

Student Information

First Name *
Middle Initial
Last Name *
Bronco ID *

Undeclared Majors

** Undeclared majors are not qualified to apply to the program **
Major *
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 Test Name Score Received

Other Test Information

Other Tests Taken

Please list Test Name/Score

Course Information

Prep English Classes
** Students in Preparatory (Prep) English Classes are not eligible for the program **

Planned English Courses for Fall 2015
Prep Math Classes
** Students in Preparatory (Prep) Math Classes are not eligible for the program **
Planned Math Courses for Fall 2015
Community College Math or English Courses
No. of Units registered for Fall 2015