You must have JavaScript enabled to use this form. Coyote ID Last Name First Name Mailing Address Mailing Address 2 City State - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Phone Email Class Level - Select -FreshmanSophomoreJuniorSenior Major Cumulative GPA CSUSB GPA Expected Date of Graduation Please note that questions 1-3 are required. 1. Tell us about your academic achievements and career goals. 2. Please share some of your responsibilities and commitments outside of your academics. (E.g. Involvement in the EOP program, campus activities, community organizations, and/or other volunteer work.) Note: If you haven’t been able to be involved outside of your academics, feel free to share with us why. 3. Tell us about yourself (e.g. share your hobbies, interests, passion projects, or anything else you’d like to share) Please answer one of the following questions. 4. How will this Book Award help you in achieving your educational goals? 5. Tell us about a challenge you’ve experienced and how you overcame it.