Application – Honors Program

For more information on the Honors Program, please see the Honors Program web page or contact Dr. Teasdale.

Contact Information:
	Name
	Street Address
	City, State, ZIP code
	Primary Phone #
	Secondary Phone #
	Email Address
Academic Information:
	Student ID
	Number of credit hours successfully completed as of 12/2007
	GPA
Honors Program Information:
	When do you plan to do your Honors Thesis?
	If you plan to use the summer to do part of your thesis work, please indicate the range of dates you would be available between June 1st – August 15th.
	In the boxes below, please list the names of the faculty members you would like to work with, along with a brief explanation of your reasons for choosing that faculty member. (The boxes will expand if necessary.) Make sure you have contacted each of the faculty before you submit their names. If you do not have three choices, you can leave some of the boxes blank. If you do not have a strong preference as to first or second choice, please indicate that in your paragraphs below.
	First Choice:
	Second Choice:
	Third Choice:
	Is there other information you would like the department to know as they evaluate your application?
	Are there any questions you have regarding the Honors Program?

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