PREM Scholarship Application
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Name
Name
*
First
Last
Email
*
UTA ID
*
Department
*
Year
*
Year
Junior
Senior
Total SCH:
*
GPA
*
Expected Graduation Date:
*
Gender:
*
Gender:
Male
Female
Other
Prefer not to respond
Ethnicity/Race:
*
Ethnicity/Race:
African American
American Indian or Alaska Native
Asian
Native Hawaiian/Other Pacific Islander
White
Hispanic or Latino
Multiple Ethnicity
Do not want to disclose
US Citizen or Permanent Resident
*
US Citizen or Permanent Resident
Yes
No
In the space below briefly describe the reasons you are interested in materials science and engineering research
*
Maximum of
250
words allowed.
Currently Entered:
0
words.
Interested in joining a materials-related graduate program upon your graduation
*
Interested in joining a materials-related graduate program upon your graduation
Yes
No
Not certain yet
Any additional information you want to share
*
Maximum of
250
words allowed.
Currently Entered:
0
words.
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