Kristina Samokhina

I declare that the information I have supplied on this form with respect to my application to CollegeSolved’s University Bridge Program is, to the best of my understanding and belief, complete and correct. I understand that giving false or incomplete information may lead to the refusal of my application or cancellation of enrollment. I have read and understand the published course information in the brochure or website and I have sufficient information about University Bridge to enroll.

I give CollegeSolved permission to obtain official records from an educational institution attended by me. I grant CollegeSolved permission to provide PVCC, College of Marin, and/or College of San Mateo with any information pertaining to my application of study, my ongoing academic progress, and my results and attendance for the purposes of admission and transfer. I understand that CollegeSolved may collect, store and use personal information only for the purposes of administering prospective, current and graduate student admissions, enrollment and education, and that the information collected is confidential and will not be disclosed to third parties without my consent, except to meet government, legal or other regulatory authority requirements. I understand that if I have applied through University Bridge and/or an approved CollegeSolved agent, any information contained in my University Bridge application may be released to that agent.

I understand and accept all of the terms and conditions as set forth in the General Terms and Conditions (the “Terms”), as may be amended from time to time and as set forth on the University Bridge website (https://www.ubridge.org/terms-and-conditions/)

I understand that fees may change without notice. I accept liability for payment of all fees as explained in the Terms, and I agree to abide by the Refund Policy, which is current at the time of my studies at University Bridge. I understand that living expenses in the United States may be higher than in my own country and I confirm that I am able to meet these costs.

I have read and accepted the affirmation. I declare that the information I have supplied in this form is, to the best of my understanding and belief, complete and correct.

I grant University Bridge and CollegeSolved permission to provide my parent(s), guardian(s) and agent, when requested, with any relevant official records of my progress at University Bridge and other information pertaining to my application to study, ongoing academic progress, results and attendance.