Tulane University - Department of Chemistry

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Application Date: 17-May-08

First Name		Middle Name
Last name		Gender: Male: Female: (optional)

Present Address:		Permanent Address:
Street		Street
City		City
State		State
Zip		Zip
Country		Country

Phone
Email Address

Biographical Information :
Date of Birth:	City:	State:	Country:
Country of Citizenship:	If not a U.S. citizen , specify visa type:

Educational Information
Are you in a presently pursuing a post-graduate degree in a chemistry related area?			Yes: No:
Are you presently employed in a chemistry related area?			Yes: No:


Universities attended and the degrees awarded, listing most recent first.
Name of University:	Dates Attended: (mm/yy to mm/yy)	Degrees Pursued:	Earned Degree?
	to		Yes: No:
	to		Yes: No:
	to		Yes: No:
	to		Yes: No:

Grade Point Averages (on a 0 to 4.0 scale; 4.0 = A average; 90 % or better)
GPA All Undergraduate Courses:		GPA Courses in Major:		GPA Courses for Graduate Credit:

Please indicate which of the following courses you have taken and provide your grade in that course (if multiple courses taken in an area, please report the average grade)

Biochemistry	Grade:	Polymer Chemistry	Grade:
Inorganic Chemistry	Grade:	Genetics	Grade:
Instrumental Analysis	Grade:	Microbiology, intro.	Grade:
Organic Chemistry	Grade:	Physiology, intro.	Grade:
Physical Chemistry	Grade:

General Physics	Grade:
Modern Physics	Grade:

Calculus	Grade:
Differential Equations	Grade:
Linear Algebra (Matrix Alg.)	Grade:

List Other Chemistry/ Physics / Biology Courses you have taken.

Required Tests:
Please self-report your test scores below. All applicants must have taken the Graduate Record Examination (GRE) within five (5) years of enrollment. International applicants whose native language is not English must also take the TSE (preferred) or the TOEFL. Official test scores must be requested from ETS and sent directly to Tulane.
GRE :
Date Taken:
Verbal:	Quantitative:	Analytical Writing:

TSE or TOEFL:
Date Taken:	Score:

References:
List the name and e-mail address of at least one (1) of your professors willing to submit a letter of recommendation on your behalf upon our request.
First Name:	Last Name:	Affiliation:	Email Address :
First Name:	Last Name:	Affiliation:	Email Address :

Personal Statement:
Please briefly state your reason for wanting to work toward a Ph.D. in Chemistry and your career goals. (Limit 200 words)

For those who fill out the application completely, Tulane’s Chemistry department will review the submitted information and inform the applicant within a few weeks of that their application has been placed in one of three categories:

conditional acceptance (the student will be officially accepted once official letters of recommendation and transcripts have been received.)
likely acceptance (the students will be accepted into the program if official letters of recommendation and transcripts strongly support the students qualifications.)
not likely to be accepted (the student is unlikely to be accepted, unless the letters of recommendation and other supporting documents speak highly of the student’s qualifications or account for circumstances leading to poor performance.)