Eastern Michigan University Department of Chemistry

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Application for Admission to the Graduate Program

1. This form is for Departmental use only, and each applicant must also submit a separate application to the EMU Graduate School. You need not supply transcrpits with this form, but be sure to send them to the Graduate School with your application.

2. If you are applying for financial aid in the form of a Graduate Teaching Assistantship, you must have three letters of recommendation sent to the Graduate Coordinator, Department of Chemistry. These letters may be from former professors and/or employers. In addition, complete the Graduate Assistantship form and send it to the Graduate School.

Name (Last, First) and Date

Present Address (Street, City, State, Zip)

Present Telephone Number

(      )

Present Employer and Address

Permanent Address

Education:

College	Major	Dates
		Entered	Left	Degree Received

Indicate your native language if other than English:_________________

Area(s) of interest in the field of Chemistry:

Ultimate Professional Goal (teaching, industry, Ph.D.):____________________

Date you wish to begin study:____________________   Full-time:____ Part-time:____

Are you applying for an assistantship?  Yes___  No___

Signature

On the reverse side of this page, give any further information that you consider pertinent to this application.

Mail to: Graduate Coordinator, Department of Chemistry, Eastern Michigan University, Ypsilanti, MI 48197