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James Holmes University of Illinois Application

James Holmes University of Illinois Application

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Published by Chaebai
University of Illinois
University of Illinois

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Published by: Chaebai on Sep 06, 2012
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05/13/2014

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APPLICATION FOR ADMISSIONTO THE GRADUATE COLLEGE
University of Illinois Identification Number (UIN)*:Application Type:Program Information:
ProposedProgram: Degree:Term: FacultyMember:Concentration/Specialization: Other Specialization:I intend to continue for the doctoral degree:
Applicant Information
LastName: MiddleName:FirstName: NickName:PreviousName: Gender: Date ofBirth:BirthCity: Birth State: Birth Country:CountryofCitizenship: Dual CitizenshipCountry:Countryof Legal Permanent Residence:Citizenship Type: Resident Alien Number:EthnicityIdentification: Race Identification(s):
 Native Language:
ContactInformation
E-mail Address:CurrentAddress PermanentAddress 2: 2:3: 3:City: City:County: County:State: State:Province: Province:Zip: Zip:Country: Country:Phone(U.S): Phone (U.S):Phone(International): Phone (International):
* The University of Illinois Identification Number is used for internaltracking purposes and is assigned post-application submission.
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United Statesof AmericaHolmesEagan12/13/1987CASan DiegoJamesMaleUnited States of AmericaUnited States of AmericaU.S. CitizenNot Hispanic or LatinoWhiteSan DiegoCA92129United States of AmericaSan DiegoCA92129United States of AmericaNeuroscience--PHDFall 2011Cognitive NeuroscienceNoneNot ApplicNeuroscience--PHDDomestic
 
ApplicationforAdmission to the GraduateCollege
Illinois Residency Information
Willyou have lived in Illinois (for non-educational purposes) for at least 12 months preceding the term for which you areapplying?Has at least one of your parentsmaintained a permanent residence in Illinois for 1year or more?Parent First Name:Parent Last Name:
AddressLine1: Address Line2:City: County:State: Zip:
Application Fee Waiver Information
EmployeeType: Designated Program:AlliedAgency: Allied AgencyPhone:
Financial Aid Information
I wish to receive financial aid:TeachingAssistantship: ResearchAssistantship:Fellowship: Tuition WaiverOnly:I must receive financial aid:
Educational History Information
Institution1: Institution 2:City: City:State: State:Country: Country:Degree: Degree:DegreeTranslation: Degree Translation:AttendedFrom: Attended From:AttendedTo: Attended To:DegreeAwarded/Expected: Degree Awarded/Expected:Major: Major:OtherMajor: Other Major:Minor/Concentration: Minor/Concentration:Honors: Honors:GPA:GPA:MajorGPA: Major GPA:GPAScale: GPA Scale: Non-NumericalGPAScale: Non-NumericalGPAScale:
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NNIllinoisY3rd Choice4th Choice2nd Choice1st ChoiceNUniv of Cal RiversideRiversideCaliforniaUnited States of AmericaBachelor of Science09/200606/201006/15/2010NeurosciencePhi Beta Kappa3.943.854.0
 
Application for Admission to the Graduate College
Institution 3: Institution 4:City: City:State: State:Country: Country:Degree: Degree:Degree Translation: Degree Translation:Attended From: Attended From:Attended To: Attended To:Degree Awarded/Expected: Degree Awarded/Expected:Major: Major:Other Major: Other Major:Minor/Concentration: Minor/Concentration:Honors: Honors:GPA: GPA:Major GPA: Major GPA:GPA Scale: GPA Scale: Non-Numerical GPA Scale: Non-Numerical GPA Scale:
 ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________  _____ 
Institution 5: Institution 6:City: City:State: State:Country: Country:Degree: Degree:Degree Translation: Degree Translation:Attended From: Attended From:Attended To: Attended To:Degree Awarded/Expected: Degree Awarded/Expected:Major: Major:Other Major: Other Major:Minor/Concentration: Minor/Concentration:Honors: Honors:GPA: GPA:Major GPA: Major GPA:GPA Scale: GPA Scale: Non-Numerical GPA Scale: Non-Numerical GPA Scale:
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