Questions marked with an asterisk (*) are mandatory.

1	* Semester Fall Spring Summer

2	* Year 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

3	* Name: First, Maiden (Female), Last

4	* Permanent Address

5	* Phone (include area code)

6	* GRADUATE SCHOOL: APPLIED

7	* GRADUATE SCHOOL: ACCEPTED

8	If Yes, SCHOOL AND FIELD:

9	* EMPLOYMENT: RECEIVED OFFER

10	HOW MANY OFFERS?

11	* EMPLOYMENT: ACCEPTED POSITION

12	If yes, COMPANY AND ADDRESS:

13	BUSINESS PHONE (include area code):

UNDERGRADUATE PROFILE

14	* What is your major? Computer Science Information Technology

15	YEARS REQUIRED TO COMPLETE THIS DEGREE:

16	* Computer Science Option Applied(Db, Net, Graphics, eComm, Acct, Econ, Mgmt, Mark, MusBus, MassComm) Technical(SpaceSci, HPC, Theory, Bio, BioTech, Chem, Math)

17	OPTION AREA:

WORK/RESEARCH EXPERIENCE:

18	* INTERNSHIP/CO-OP:

19	COMPANY/AGENCY (Internship):

20	* WORK CS Related Not CS Related

21	* WORK Full-Time Part-Time

22	* UNDERGRADUATE RESEARCH Paid Course Credit Volunteer

23	VOLUNTEER: Dept. Tutor Dept. Lab Assistant Local School System

24	CO-CURRICULAR ACM ACM OFFICER/COMM CHR. UPE HONOR SOCIETY PROGRAMMING TEAM CSC HONDA ALL-STAR CHALLENGE WSSU HONORS PROGRAM ALPHA KAPPA MU HONOR SOCIETY WSSU SGA WSSU CAMPUS PALS WSSU NEWS ARGUS WSSU PERFORMING GROUP(Band, Choir, Wind Ensemble) WSSU SPORTS (Football, Basketball, Tennis, Volleyball, etc)