First Name
(as it appears on your identification)
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Last Name
(as it appears on your identification)
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Berkeley Email (required) |
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Non-Berkeley Email |
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Phone |
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SID (if not a Cal student, enter your school or program name) |
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Expected Graduation Year |
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Are you a transfer student? |
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Are you a first-generation college student, meaning your parents, guardians, or grandparents did not attend college? |
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What is your major? |
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What is your residential status? |
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Hometown |
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What languages do you speak other than English? |
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If you selected “Other”, or would like to provide details about your gender identity, please do so here. |
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Racial or ethnic identity |
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If you selected “I do not identify with the above options”, or would like to provide details about your race/ethnicity, please do so |
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How did you hear about this program? |
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Would you like to subscribe to the Public Service Center’s monthly newsletter that lists community events, service and leadership opportunities, scholarships, and more? |
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The Public Service Center is committed to raising funds for those who need it.
Please share your financial aid status with us to help us make this happen. (Please check all that apply.)
Note: 65% of undergraduates receive some form of financial aid
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Please list any dietary preferences or needs you may have. |
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Please indicate whether you live in the Residence Hall, a co-op or are a member of a Fraternity or Sorority. |
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Have you participated in any Public Service Center Programs? If so, please select which ones. Use the CTRL key to select multiple programs. |
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Are you applying to any other internship or leadership programs in the upcoming school year? If so, please list them here.
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