NORTHWESTERN UNIVERSITY
Interdisciplinary Biological Sciences Program
Application Fact Sheet – For Fall 2016 Admission
(Please supply all applicable information requested on this sheet)
Female
NAME
Last/Family
GENDER
First/Given
US Citizen or Permanent
Resident
Date of Birth (Month/Day/Year)
Yes
Male
If no, list visa status or
country of citizenship
No
Street Address
CONTACT
INFORMATION
Zip/Postal Code
EDUCATION
Graduation Date (M/Y)
POSTGRADUATE
EDUCATION
GRE
SCORES
City and State/Province
Country
Work/Lab Phone
Home Phone
E-mail Address
Cell Phone
University/College
Degree and Major
Cumulative GPA¶
Major GPA¶
University/College
Class Rank and Size
Degree and Major
Graduation Date (M/Y)
Cumulative GPA¶
Major GPA¶
Class Rank and Size
Verbal
Quantitative
Analytical Writing
TOEFL*
RESEARCH EXPERIENCE (ALL APPLICABLE INFORMATION MUST BE PROVIDED ON THIS SHEET)
RESEARCH ADVISOR
PROJECT PERIOD
PROJECT TITLE
¶
If GPAs are unavailable, provide % scores; *International applicants only, score must be higher than 577 (PBT) or 90 (IBT) to be
eligible for admission.
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NORTHWESTERN UNIVERSITY
Interdisciplinary Biological Sciences Program
Application Fact Sheet – For Fall 2016 Admission
(Please supply all applicable information requested on this sheet)
AREA(S) OF INTEREST:
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Biotechnology, Systems & Synthetic Biology
Cancer Biology
Cell & Molecular Biology
Chemical Biology & Drug Discovery
Developmental Systems & Stem Cell Biology
Genetics & Genomics
Immunology & Microbial Sciences
Neurobiology
Reproductive Science
Structural Biology & Biophysics
OTHER INFORMATION (PRIZES, ACCOMPLISHMENTS, ETC.)
PLEASE INDICATE WHAT RESOURCES WERE HELPFUL TO YOU IN DECIDING TO APPLY TO THE IBIS PROGRAM:
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IBiS web site
IBiS Facebook page
Materials received from program
Faculty member/Academic advisor
Please return this form via mail to:
Admissions
IBiS – Hogan Hall 2-100
Northwestern University
2205 Tech Drive
Evanston, IL 60208-3500
Or via e-mail to:
ibis@northwestern.edu
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