Application for Graduate Financial Support

DEPARTMENT OF CHEMISTRY AND BIOCHEMISTRY

PERSONAL INFORMATION:

Last (Family) Name*: First (Given) Name*: Middle Initial:

E-Mail*:

Mailing Address (Street/PO Box)*:

City*: State*: Zip*: Country:

TELEPHONE NUMBER Day : Night:

Date of Birth (mm-dd-yyyy)*:

Sex*:
Male
Female

U.S Residents

If other than U.S. citizen: Citizenship

Have you every applied to this department before*?YES NO

If so, what year did you apply?

Degree Desired*: MS PhD

PROPOSED MAJOR FIELD OF GRADUATE STUDY*: You may indicate more than one field.

Analytical Biochemistry Inorganic Organic

Physical Chemical Education Chemical Physics Theoretical

Special interests or remarks:

EDUCATION: A transcript from each school attended for undergraduate and graduate studies is required and should be sent to: Graduate Programs Office, Texas Tech University, Dept. of Chemistry and Biochemistry, Lubbock, TX 79409-1061

In the meantime, a preliminary evaluation of your application can be made on the basis of the following, summary information.

MS Thesis Title:
MS Thesis Mentor:

GRE SCORES: The General GRE scores are required by the Department of Chemistry & Biochemistry . If you have taken these exams, please provide the results. If you have NOT taken the general GRE, please arrange to do so as soon as possible and report the scores when you get them.

Exam date: Verbal: Quantitative: Analytical Writing:

The Advanced Chemistry Examination is NOT required, but if you have taken it, you may report the results here.
Advanced Chemistry Exam:
or Advanced Biochemistry Cell & Molecular Biology Exam:

Test of English as a Foreign Language:
The TOEFL is required of all applicants who are residents of countries for which English is NOT an official language.
TOEFL Score:    Listening Score:
If you have not taken the TOEFL exam but are planning to, when is your scheduled test date?

International English Language Testing Syystem:
The IELTS score may be reported in place of the TOEFL score.
IELTS Score:
If you have not taken the IELTS exam but are planning to, when is your scheduled test date?

EXPERIENCE: (Describe briefly any work involving chemistry or related sciences that you have done.)

PUBLICATIONS (Give authors' names, titles, and references):

HONORS (List any honors you have received, including memberships in honorary societies and offices held in them):

PROFESSIONAL SOCIETIES (List any professional societies of which you are a member or affiliate and offices held in them)

Letters of Recommendation

REFERENCES (List at least three persons who know your work well and give their contact information including email address. Faculty members at institutions where you have studied or are studying are preferred. If you have done or are doing graduate study elsewhere, at least one reference letter should be from that graduate department.) We will not ask these people to provide a reference for you -- you must contact them.

Upon submission you will receive a confirmation.  If you do not see this, please click here. Thank You.