PHD Program in Basic and Translational Science: Application
Clinical & Translational Science Institute of Southeast Wisconsin
Due July 15, 2014
NAME
WHY ARE YOU INTERESTED IN THE PhD IN BASIC AND TRANSLATIONAL SCIENCE PROGRAM?
FIRST YEAR GPA
FIRST YEAR COURSES WITH GRADES AND CREDITS
IF GRADUATE SCHOOL OR IF MEDICAL SCOOL, COURSES WITH GRADES ONLY.
COURSE NUMBER
COURSE NAME
CREDITS
GRADE
MENTOR
PhD DISSERTATION RESEARCH AREA
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HOW IS YOUR PhD DISSERTATION RESEARCH AREA TRANSLATIONAL?
WHAT IS A TRANSLATIONAL DISSERTATION AIM THAT MAY BE PART OF YOUR DISSERTATION?
HOW MIGHT THE RESULTS OF YOUR TRANSLATIONAL AIM HELP A PATIENT?
PLEASE ATTACH A BRIEF SIGNED STATEMENT FROM YOU MENTOR ACCEPTING YOU AS A
STUDENT IN THE PHD IN BASIC AND TRANSLATIONAL SCIENCE PROGRAM.
Return to Angie Gord in the Graduate School Office as an electronic file (agord@mcw.edu) or in hard
copy.
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