Name

First Name

Last Name

Major(s)

Current Year/Class

Expected Graduation Date

YYYY

Phone Number

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date 1

YYYY

If you are interested in being paired up with a BKAA alumni mentor, please check this box

Signature

I hereby certify that I am presently an undergraduate enrolled at the University of California at Berkeley. I also certify that all of the information contained in this application and the documents submitted with this application are true and correct. I hereby authorize the Berkeley Korean-American Alumni Association to obtain information from my school, my employer, and other sources to confirm the information provided with this application.

In addition to this application form, please submit:
1. A copy of an unofficial transcript;
2. Your resume; and
3. A personal statement that describes: (a) the applicant's financial status, including any financial aid being received and the applicant's present employment, if any; (b) the applicant's scholastic achievements and/or other awards or accomplishments; and (c) the applicant's past or current service to the Korean American community and/or the applicant's plans to serve the Korean American community in the future.