UC Merced Inquiry Form

Personal Information

Student First Name

Student Last Name

E-mail Address

Confirm E-mail Address

Student Date of Birth

Would you like to receive information about UC Merced by mail?

Student Enrollment Information

Student Type

Start Term

Year

Anticipated Major

Current School Name

If you don’t see your school, type Unknown.

Contact Information

Phone Number

Mobile Opt-In

Yes

Address Line 1

Address Line 2

Address Line 3

City

State/Province/Region

Zip/Postal Code

Country

Please review the information you have provided. Once you click the SUBMIT button you will not be able to return or change your entries