TEXAS WOMAN’S UNIVERSITY BRIDGES PROGRAM APPLICATION FORM APPLICATION DEADLINE MARCH 15 1. Complete the following (Please print legibly) First Name ___ Last Name Are you a U.S. citizen? Yes No Social Security Number Ethnicity: (Optional - Please circle) African American Alaskan/ Native American Hispanic American Rural Appalachian _) Cell: ( U.S. Pacific Islander Phone number with area code: Day: ( ) Evening: ( ___ ) Email: ___ Address: Street/PO Box City State ___ Zip Emergency Contact: Name: Relation: Current Major: Phone:( Career Goal: ) _____ ___ Which community college do you attend? __ When did you enter community college? ___ Is this your first semester? Yes No Completed semester hours: Expected graduation date: Current enrollment hours: Current GPA: List all other colleges or universities attended including dates: ____ _____ _____ 1 List the courses that you are taking this semester: _____ __ ___ __ __ 2. Attach a brief essay (maximum one page double spaced) about your interest in research and / or science and tell why you are interested in the BRIDGES Program. 3. Have two letters of recommendation from college professors sent to the BRIDGES program coordinator. At least one recommendation must be from a science teacher. Provide the names and phone numbers of your references below. Reference one: Name Phone number ( ) ______ Phone number ( ) ________ Reference two: Name 4. Complete a Texas Commons Transfer application and return it to the BRIDGES Program Coordinator at your Community College: CCCCD = Dr. David McCulloch (972)-881-5991 email: dmcculloch@cccd.edu Brookhaven College = Doris Rousey (972) 860-4750 email: DRousey@dcccd.edu TCC = Charlene Cole (817)-515-6340 email: charlene.cole@tccd.edu 5. Request official transcripts from all previously attended institutions be sent to TWU at TWU Student Records Processing, PO Box 425649, Denton, TX 76204 Check List: Please check each item submitted or requested. (Note: Incomplete Applications will not be reviewed by BRIDGES Committee.) BRIDGES Application and Essay Texas Commons Transfer Application 2 Letters of Recommendation Official Transcripts 2