Name:

Oswego email: 

Student ID:

Major:

Current Standing:          Freshman          Sophomore           Junior          Senior

Classes taken/taking (check all that apply):  Biochemistry         Molecular Biology             General Chemistry         Organic Chemistry         Physiology         Physics

Approximate Cumulative GPA: 

Sciences GPA:

Career Goal:

Semester willing to start: 

Number of semester willing to work: 

How do you wish to work (check all that apply)?  
 Unofficial research (no credits, less commitment)
 Independent Study (Bio 399/499) (3 credits = 9 hrs/wk, 60 credit hours min. required)
 Directed Research (Bio 296) (3 credits = 9 hrs/wk, open to Sophomores only)
 Work Study (paid, no course credit, hrs/wk will depend on financial qualifications)

Do you qualify for the Federal Work Study Program?   Yes   No

Are you willing to work weekends?    Yes    No

Do you have another job?  If yes, where and how many hours a week?

Please indicate which project you are interested in, in rank order if there are more than one (see list of possible projects under "Student Research Opportunities").

I hereby give my permission to Dr. MacKenzie to review my transcripts and talk with other professors, with the understanding that everything will remain confidential.     I agree        I disagree