Today's Date: 

Name: 

Local Address:

Email Address: 

Phone Number: 

Major(s): 1st- 2nd- 

Semester/Year Major Declared:

Graduation Date (anticipated): 

1. Do you have a specific field of interest?

2. Are you considering applying to graduate or professional schools after finishing your undergraduate work? If so, what sort of advanced education are you considering? 

3. List two choices for your faculty advisor. Please choose from the current list of available advisors.
1st Choice:    Steve Churchill  Ken Glander  Daniel Schmitt  Leslie Digby  Christine Drea 

2nd Choice:    Steve Churchill  Ken Glander  Daniel Schmitt  Leslie Digby  Christine Drea 

[note: if you would like to add either Dr. Brian Hare or Dr. Chris Wall as your choice of advisor, please do so in the space below]

4. Are there any special circumstances or information that would assist us in the process of assigning you an advisor?

FILL OUT THIS SECTION ONLY IF YOU ARE CURRENTLY ASSIGNED TO AN ADVISOR.

CHANGE OF ADVISOR

Current Advisor: 

New Advisor Requested:
1st Choice    Steve Churchill  Ken Glander  Daniel Schmitt  Leslie Digby  Christine Drea 

Please remember that if an advisor has already reached the limit for equal distribution of advisees you may be assigned to a new advisor of our choice. You may re-request your first choice the following semester.