STEM Education Graduate Certificate
Admission Application
PERSONAL INFORMATION
LAST NAME:
FIRST NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
EMAIL ADDRESS:
PHONE NUMBER:
GRADUATE PROGRAM INFORMATION
Are you currently enrolled in
a graduate program at
Michigan Tech?
Yes (please complete the following)
No (skip to previous degree information)
MTU GRADUATE
PROGRAM:
LEVEL OF PROGRAM:
MASTER'S
PH.D.
NAME OF ADVISOR:
DATE OF ENROLLMENT:
G.P.A.:
PREVIOUS DEGREE INFORMATION (GRADUATE OR UNDERGRADUATE)
NAME OF UNIVERSITY/
COLLEGE:
MAJOR:
DEGREE EARNED:
DATE DEGREE AWARDED:
G.P.A.:
PREVIOUS DEGREE INFORMATION (GRADUATE OR UNDERGRADUATE)
NAME OF UNIVERSITY/
COLLEGE:
MAJOR:
DEGREE EARNED:
DATE DEGREE AWARDED:
G.P.A.:
STATEMENT OF PURPOSE
(Why are you interested in
earning a graduate certificate
in STEM Education?)
Please return the completed application to Judy Hilss (106 Meese Center or juanders@mtu.edu).
If you are not currently enrolled as a graduate student at Michigan Tech, you will also need to
complete a graduate school application. See http://www.mtu.edu/gradschool/admissions/apply/ for
details.