Information Request Form

If you are interested in the Program in Applied Mathematics and would like more information about us or to talk to a Professor or Student in the Program, please fill out as much of this form as you like. The more we know about you, your interests and your background, the more feedback we can give you about how the Program would suit you.

Contact info

First Name:

Last Name:

Address

City, State, Zip:

Country:

Email:

Home Phone:

Which application?

Domestic: U.S. Citizen, U.S. National (resident alien or permanent resident)
International: All others

Your plans

Expected date of graduate enrollment:

Which general area(s) of Applied Mathematics are you interested in? Please check all that apply:

Applied Analysis

Biomathematics

Computational Science

Fluid Mechanics

Nonlinear Dynamics

Mathematical Physics

Partial Differential Equations

Pattern Formation

Signal Processing

Medical Imaging

Others - please specify:

Undergraduate record

Undergraduate Institution

Undergraduate Major: Major GPA

Undergraduate Minor: Overall GPA:

GRE

Verbal: Quantitative: Analytical:

Subject Test^*: Score:

If GRE has not yet been taken, please indicate when you plan to take it:

* Optional

Projects

Have you done (or do you plan to do) an undergraduate research project, senior thesis, or other capstone or enrichment activity?

Yes No

If so, please describe it briefly below:

Graduate Work

Have you done any graduate work?

Yes No

If so, please describe it briefly below:

Miscellaneous

Please use this box to ask questions or give us any additional information:

Would you like to arrange an appointment (in person or via telephone) with the Head of the Program?

Yes Not at this time

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