Dear Graduate Student,
Department of Biomedical Engineering
Undergraduate Student Information Sheet
Date:
First Name: Last Name:
Preferred Name: 10 Digit USC ID Number:
Circle One: BME BME Chemical BME Mechanical BME Electrical
BME Specialization: Biochemical Bioelectronics Biomechanics Neuroengineering Unsure
Circle One: Freshman Sophomore Junior Senior 5th Year+
Catalog Year: GPA:
Year of Entrance to USC: Expected Graduation:
Phone: ( ) ______ USC E-mail Address: ____
Hometown: ________________________________
Are you a double major? Y or N If yes, in what? Do you have a minor or plan to? Y or N If yes, in what?
Are you Pre-Health? Y or N If Yes: Pre-Med Pre-Pharm Pre-Dental
Did you transfer to USC from another College? Y or N If yes, from where?
Are you a student athlete? Y or N
Are you involved in any USC clubs and organizations? Y or N
Are you a member of a Fraternity or Sorority? Y or N
Are you the first person in your family to attend college? Y or N
Are you the recipient of any USC scholarships? Y or N If yes, which ones?
Are you a Merit Research student? Y or N
Do you have a job? Y or N If yes, how many hours per week?
Are you currently conducting research? Y or N If yes, which professor?
Do you have obligations other than school and work? Y or N
Ethnicity: (circle all that apply)
Asian Black/African American Caucasian
Latino/Hispanic Native American Other
What did you do this summer?
Do you have any suggestions or ideas that would improve your advisement experience?
What are your post-graduation plans?
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