Sign in to your Google account to fill out this form
This form contains features which require sign in. Your identity will not be revealed.
Responses cannot be edited
UCBHSSP Summer Program Application
The UC Berkeley History-Social Science Project, with a partnership with the Stuart Foundation, is excited to host the first Making History summer program aimed at connecting students to the historical narrative, the history of their communities, and themselves. The program will take place from July 5-28 at UC Berkeley, from 9 am-3 pm daily. Participants will also travel as a group to historic sites around the Bay Area. If you are interested in attending, please fill out the application below. The deadline to apply is April 23 at 11:59 pm.
Date of Birth
Name of high school
Name of current history teacher
Grade student will enter in September 2017
Parent/Guardian phone number
Student phone number
Parent/Guardian email address
Student email address
Preferred method of contact
Language(s) spoken at home
How did you hear about this program?
Which topics of US History most interest you? You may choose more than one option.
the Dust Bowl
The New Deal
Women in World War II
The Free Speech Movement
The Black Freedom Struggle
In 1-2 paragraphs, explain why you are interested in attending this program. Include, if applicable, specific things you hope to learn more about your community and Bay Area history. We encourage you to write these paragraphs in a Word document, proofread and revise, and copy and paste your final revision here.
If you have any further questions, or will require special accommodations, please use the space below to explain.
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service