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					 Civil & Environmental Engineering Intake Form
Name:                                               Email:

Concentration you are
                               ☐ Environmental ☐Water Resources ☐ Materials
applying to:
                               ☐ Transportation ☐ Structures ☐Geotechnical
(Please only choose one)

Degree program you are
                               ☐Master’s Thesis ☐Master’s Coursework ☐PhD
applying for:

Attending:                     ☐ Full-time    ☐ Part-time

Applying for Peace Corps
                               ☐Yes ☐ No
Master’s Int’l Program:
Have you already spoken to a
                                 ☐Yes ☐No
Professor about working in
                               If yes, Professor’s name:
their research group?

Do you have:                   ☐ Self-Supporting ☐ Existing Fellowship ☐ Other



Are you seeking:               ☐ Scholarship ☐ RA ☐ TA


Are you:                       ☐ US Citizen ☐ US Permanent Resident ☐ International
                               Verbal:      Quantitative:       Analytical:
                               Will you be sending FE or PE verification in lieu of GRE scores (note
GRE Scores:                    verification must be sent directly from the state PE board to graduate
                               admissions. FE/PE verification may only be substituted for the GRE for
                               masters students.)? Yes ☐ No☐
                                              Degrees:

                               School: __________________________________________

B.S. Degree:                   Major: ____________________________

                               GPA: _________




Revised 6/6/11
                              School: _________________________________________
Additional Degrees if
                              Major:____________________________
applicable:
                              GPA:_________

                                                                              Continue on next page→




                                             References:

                                         Please enter the names and email address for your
                                         references. Note: Master’s International and PhD
                                         applications should provide three (3) references; all others
                                         may provide two (2).

 Have you already requested that your    Reference #1:___________________________________
 references be contacted online via
                                                  Email:___________________________________
 USF graduate admissions?
                                         Reference #2:___________________________________
  ☐ Yes    ☐ No
                                                  Email:__________________________________

                                         Reference #3: ___________________________________

                                                 Email:___________________________________

 On the following page, please provide a brief statement (less than 50 words) summarizing your
 background and research interest:




Revised 6/6/11
Revised 6/6/11

				
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