Self-Reported Transferable Undergraduate College GPA

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Office of University Admissions

Self-Reported Transferable Undergraduate College GPA

Please print and complete this form.

Our records indicate that you may have omitted some important information on the Undergraduate Application for Admission. So that we can continue processing your application, please provide the required self-reported item(s) below:

Term applied:  CIN:

Item(s) Required:
All Transferable Undergraduate College Work GPA:

Please read and sign the Certification, make a copy for your records and return the original directly to the Student Information Center, located in Student Affairs 101, within 10 business days. Hours: Monday - Thursday, 8:00 a.m. to 6:00 p.m., and Friday, 8:00 a.m. to 4:00 p.m. You may also mail the completed original to:

CSULA Admissions Office
5151 State University Drive
Los Angeles, CA 90032-8530

If you are admitted, your acceptance letter will ask you to verify your intent to enroll for the term. To avoid registration delays, official transcript(s) from all schools must be received within three weeks of your acceptance letter and no later than seven days prior to enrollment.


Certification - Read and Sign to Certify the Accuracy of the Information Provided

I certify, under penalty of perjury under the laws of the State of California, that I have provided complete, and accurate responses to the item(s) on this form. I authorize The California State University to release any information submitted by me in connection with my application to any person, firm, corporation, association, or government agency, but only to verify or explain the information I have provided, to obtain other records necessary for my application, or in connection with perjury proceedings. My signature certifies the accuracy and completeness of the information provided. I understand that any misrepresentation may be cause for denial or cancellation of admission or enrollment.

Print name:  
(Last) (First)

Signed at    
City and County Applicant’s Signature Date


Office of University Admissions