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STUDENT TRAINEE SUPPLEMENTAL FORM APPRENTICE SAN DIEGO NAME LAST FIRST LEGAL MIDDLE FULL MAILING ADDRESS CITY STATE HOME PHONE WORK PHONE MESSAGE PHONE ZIP CODE As a candidate for Student Trainee I can meet the following requirements.

I am currently enrolled in a full-time undergraduate course of study from an accredited college or university. I completed all the above requirements in high school. (If currently enrolled in high school, give year of graduation: /) I am legally qualified to work in the United States or have obtained an extension of legal status. (If currently enrolled in high school, give month/year of graduation: /) I am a member of the Armed Forces. I am currently stationed outside the United States in the course of basic training or other military training. I will be deployed for a time not to exceed two months in a location outside the United States. Furthermore, I will work in that location at least one month from my last date of duty. (If currently enrolled in high school, give month/year of graduation: /) I am currently enrolled in a student training program outside a regular full-time college course of study. (See a list of accredited courses in the U.S.) The University or Campus can provide me with the name and current mailing address of the following: My program of study The University's campus or campus of study The College or a participating faculty sponsor (including part-time) The College's faculty sponsor (including part-time) I agree that I have complied with the above requirements and that my participation will be voluntary. A full-time undergraduate course of study is defined as 4 or more credit hours per week; 2 of those credit hours must be taken after the fall semester and before the spring semesters. (For example, a 4-credit-hour undergraduate course of study could consist of four credits of study in the fall, four credits of study in the winter, and four credits of study in spring and summer.) I agree that I will not engage in, and that any statements related to the University relating to my actions as a Student Trainee are false, misleading, and/or defamatory. I understand that I may invoke the law enforcement shield law, and am required to register my phone number and home and email addresses, when registering for this program. Furthermore, I agree to file a complaint with the Federal Bureau of Investigation in the event that my participation creates a direct or indirect conflict of interest.

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