Undergraduate Studies

Name:		Phone Number:
Major:		Email Address:
Current Standing: Freshman Sophomore Junior Senior
Current GPA:
List your preferences of Professors who you would like to work with (in order of preference)
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Chemistry, Biology, Physics and Math Courses Taken Successfully (with grades):

Chemistry, Biology, Physics and Math Courses being taken this semester:

Previous undergraduate research [List experience(s) and professor]:

Career Plans:

Interest in Research Credit: Yes No
Course:
Number of credit hours (1 credit hour = 4 hours lab time; minimum 2 credit hours):
Interest in Research for pay (very limited availability)? Yes No
Availability for Research (Days and time):