DEPARTMENT OF ENVIRONMENTAL SCIENCES
GRADUATE STUDY PRE-APPLICATION FORM
3/18/2016
1. Personal Information:
a. Last Family Name:
b. First Name:
c. MI:
d. Sex: M/F
2. Contact Information:
a. Mailing Address:
b. Telephone:
g. Email:
f. Fax:
3. Semester you wish to enter:
4a. Choose the graduate program you are interested in:
Thesis Option
4b. Make a brief statement concerning your proposed program of graduate study;
address specific areas of interest, your plans for professional development,
and possible thesis topics.
4c. Choose your priority area:
Biophysical Systems
5. GRE Scores:
Please do NOT submit this form without GRE and/or TOEFL/IELTS Scores.
We will not review this pre-application unless scores are available.
(Note: only the verbal and quantitative results are required. The writing score is optional.)
a. VERBAL
b. QUANTITATIVE
c. WRITING
6a. First spoken language:
If not English, then English Language Proficiency Test Scores (TOEFL or IELTS) are required.
(Note: the TOEFL or IELTS is required for admission of all foreign students except for students
who are citizens of Canada, Australia, New Zealand, or the United Kingdom. The TOEFL or IELTS is required
for full financial assistance.)
b. TOEFL or IELTS:
7. Colleges or Universities attended and degrees awarded (in chronological order).
(Note: if Grade Point Average, G.P.A., is not on a 4.0 scale, please convert)
(Format: School, Dates Attended, Degree Received, G.P.A. )
8. Teaching and Research Experience:
9. Honors, awards, academic distinctions:
10. Publications (complete citations, including titles):
11. Overall undergraduate GPA:
12. Grades for all lecture and laboratory courses: (Note: if grades are not based on a 4.0 grading scale,
please convert) (Examples: A=4.0, B=3.0, C=2.0)
a. General Chemistry
b. Intro. Biological Science for science majors:
c. Statistics
(e.g. BIOL 1201)
(e.g. EXST 2201 or equiv.)
13. Country of citizenship:
African American
14. Ethnic Origin:
(Required for Federal Reports by Civil Rights Act of 1964)
15. Are you applying for a graduate assistantship?
YES
16. If you do not receive financial assistance, do you have sufficient funds to support yourself?
17. Supplemental Comments:
18. How did you hear about us?
YES