Berkeley Law Application Fee Waiver Request To request a waiver, please complete the following form and submit it with proof of participation such as a verification/certification letter as soon as possible and no later than 5:00 pm, January 1. Proof of participation falls into three broad categories: Honors/Research (i.e., Fulbright, Truman Scholarship), Public Service (i.e., Teach for America, Military), and Educational/Socio-Economic Disadvantage (CYDL participant, Gates Scholar, Pell Grant recipient). See categories at the bottom of this page for a complete list; select one and provide proof of participation (required). LSAC Number Name (First, Middle, Last) (required) Select One Mr Ms Mrs Email (where notification will be sent, check the settings for your spam filter) Phone Number Address Line 1 Address Line 2 City State Zip Code Country Citizenship: Select One U.S. Citizen Permanent Resident Alien Reg # I am currently enrolled or a graduate (no more than 2 years prior to the fee waiver request) of the following public service program and will attach verification: Program Name Select One Teach for America Peace Corps Military (Active Duty or Veteran) Americorps (JusticeCorps, Americorps Vista) PPIA Capital Fellows Program City Hall Fellows Institute for the Recruitment of Teachers Presidential Management Fellowship Other... If other program please describe your participation (duration, role, etc.) and the mission of the organization as well as the community it serves. You must also include a link to the organization website. Program Verification Documentation (required for this selection) I have received the following Honors/Research Scholarship and will attach verification: Name Select One Fulbright (including teaching) Truman Scholarship Paul and Daisy Soros Fellowships for New Americans McNair NSF Fellowship Marshall Scholarship Morris K. and Stewart L. Udall Foundation Rhodes Scholarships CORO Fellowship in Public Affairs Coca Cola Scholars Phi Kappa Phi Honor Society Scholarship Verification Documentation (required for this selection) I am a participant or participated in one of the following programs and will attach verification: Name Select One CYDL Participant TRIO/Upward Bound Participant Gates Scholar Questbridge Scholar Posse Foundation Scholar College Horizons or Graduate Horizons Participant Puente Project Participant Community Colleges Pathway to Law School Participant Summer Bridge at a CSU or U.C. Participant EOP student at a CSU or U.C. Participant TRIALS Participant UCLA Law Fellows Participant UC Merced Law Fellows Participant UC Irvine POP Participant UC Davis KHOP Participant PLSI Participant Sidley Prelaw Scholarship Initiative Participant MTO Fellows Program Participant Pell Grant Recipient Cal Grant B Recipient CLEO scholars program Congressional Hispanic Caucus Institute Congressional Black Caucus Fellowship Ron H. Brown Law prep program Program Verification Documentation (required for this selection) I understand that my application fee may be waived based on the information that I have provided. I certify that all the information I have provided is true and complete. Please print full name as signature: