Interview Date:/Time:

SPRING 2017 MARINE BIOLOGY QUARTER Application

MOOREA, FRENCH POLYNESIA

Please print clearly.

Name: UID:

Major: Cum GPA:

Year in School: E-mail:

Current Mailing Address:

Current Telephone: ( )

Please answer all of the following questions completely (attach separate sheets as necessary):

Have you completed LS 1, EE BIOL 109, EE BIOL 109L, and Statistics 13 or its equivalent, or will you have completed them before Spring Quarter 2017? Please list what quarter you took or plan to take those courses and grades received.

Course / Quarter / Grade Received / Future Quarter
Life Sciences 1
EE BIOL 109
EE BIOL 109L
Statistics 13

How likely are you to enroll in the Spring 2017 Marine Biology Quarter?

q  Certain

q  Very likely but depends on my scheduling

q  Interested, but not certain

q  Outside chance

What is your background preparation? (Preference is given to graduating seniors and students with advanced training).

List all EE BIOL courses you will have taken before Spring 2017, when you took the course(s) or will take, and the grade you received.

1

Interview Date:/Time:

What EE BIOL courses do you plan to complete for the remainder of this year and next year (i.e., Spring 2016, Summer 2016, Fall 2016 and Winter 2017)?

What are your current career goals? How does the MBQ relate to these goals, if at all?

What do you hope to gain by participating in the 2017 Marine Biology Quarter?

What can you bring to the program, in terms of skills and qualifications?

Do you speak French? (not required)

q  Yes

q  No

Application deadline: Tuesday, May 10, 2016, at 4:00 p.m. Applications are to be submitted electronically to . A copy of your Degree Audit Report (DAR)/Degree Progress Report (DPR) should be attached with your application.

Applications are due no later than 5:00pm on Monday 24 November