Application to Transfer from SCS Ph.D. program to CALD Ph.D. Program in Computational & Statistical Learning Carnegie Mellon University Center for Automated Learning and Discovery Personal Data Mr. Ms. __________________________________________ Family Name Are you a U.S. citizen or permanent resident of the U.S.? __________________________________________ Given name and middle name (if any) Yes No ___________________________ Social Security Number (if any) Optional Information: If you answered No, the following information is needed to issue an INS Certificate of Eligibility (Form IAP-66 or I20). Providing this information is strictly voluntary and will not affect the consideration of your application in any way. ________________ Date of Birth ______________________ City of Birth __________________________ Country of Birth _______________________________ Country of Citizenship If you are a nonresident alien currently in the U.S., what is your immigration status? ______________________________ Contact Data _______________________________________________ Home Department _______________________________________________________ Advisor _______________________________________________ Current Address (until_________) _______________________________________________________ Permanent Address (if same as current, leave blank) _______________________________________________ _______________________________________________________ _______________________________________________ _______________________________________________________ _______________________________________________ Telephone _______________________________________________________ Telephone _______________________________________________ Electronic network mailing address Supporting Data Provide your resume along with the supporting documents from your home department which include previous application materials including GREs, transcripts,TOEFL records, recommendation letters and your current Carnegie Mellon transcripts that include at least two terms of study. You must provide letter of nomination from your home advisor and also from a potential CALD Faculty Advisor. _______________________________________________ Name _______________________________________________________ Title and affiliation Outline your research experience and list your publications, if any. (Programming and industrial experience should not be listed here.) List scholarships held, prizes, honors received, and society memberships. Briefly state your primary interest in Knowledge Discovery & Data Mining (such as robotics, machine learning, data mining, data visualization, etc.) Statement of Purpose On a separate sheet, type a one or two-page concise statement in the following format: Part I: Briefly state your objective in pursuing a graduate degree in Knowledge Discovery & Data Mining. Part II: Describe your background in fields particularly relevant to your objective. List here any relevant academic or industrial experience. Part III: Include any additional information you wish to supply to the Admissions Committee. Please mail this application to: CALD/SCS Carnegie Mellon University 5000 Forbes Avenue Pittsburgh, PA 15213-3891 _________________________________________________________________________________ Signature Date Carnegie Mellon University does not discriminate and Carnegie Mellon University is required not to discriminate in admission, employment, or of its programs or activities on the basis of race, color, national origin, sex or handicap in violation of Title VI of the Civil Rights Act of 1964, Title IX of the Educational Amendments of 1972 and Section 504 of the Rehabilitation Act of 1973 or other federal, state, or local laws or executive orders. In addition, Carnegie Mellon University does not discriminate in admission, employment or administration of its programs on the basis of religion, creed, ancestry, belief, age, veteran status, sexual orientation or in violation of federal, state or local laws or executive orders. However, in the judgment of the Carnegie Mellon Human Relations Commission, the Department of Defense policy of, "Don't ask, don't tell, don't pursue," excludes openly gay, lesbian, and bisexual students from receiving ROTC scholarships or serving in the military. Nevertheless, all ROTC classes at Carnegie mellon University are available to all students. Inquires concerning application of these statements should be directed to the Provost, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, telephone (412) 268-6684, or the Vice President for Enrollment, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, telephone (412)268-2056. Obtain general information about Carnegie Mellon University by calling (412)268-2000.