Student Information

First Name *

Last Name *

UCNJ ID# *

Last Four Number of Social Security Number * 🛈

Preferred Email Address *

Date of Birth *

Phone Number *

Phone Type *

Street Address *

City *

State *

Zip Code *

EOF Student Status *

Currently Enrolled UCC EOF Student

Former UC EOF Student

Have you participated in an opportunity program? (Select all that apply)

College Bound

GEAR UP

TRiO

UCNJ Major *

Entry into UCNJ *

Entry Term into EOF Program * 🛈

Cumulative GPA * 🛈

College Credits Earned * 🛈

Semester Graduating (i.e. May 2025) * 🛈