| Personal
Information: |
| Name: |
| | Please enter your full name, separated into
each of the 3 fields.
Example:First: David
Middle: Allen
Last: Rieds |
Date of Birth: |
| | Fill your birthdate into the fields (Format:
Month/Day/Year). Please use two digits for the month and day, and four for the year
Example:Date of
Birth: 05 / 08 / 1979 |
Current Address: |
| | Please use your current address from which
you receive mail most often (Lines 2 and 3 are optional).
Example:Line 1: 3400 N. Charles
Avenue
City: Baltimore State: MD
Zip Code: 21218
Country: United States
|
| Online
Information: |
| E-Mail address: |
| | Your current e-mail
address.
Example:E-Mail Address: dreids@jhu.edu |
Webpage Address: |
| | Your current webpage
address.
Example:Webpage: http://www.clsp.jhu.edu/index.html |
| Academic
Information: |
| Current University: |
| | Please provide your current University
information.
Example:Name: The Johns Hopkins University
State: Maryland
Country: United
States
Date of Graduation: May, 2005 |
| Faculty Nominator: |
| | Please provide your Faculty Nominator's name
and e-mail address.
Example:Name: Douglas Poland
E-Mail: dpoland@jhu.edu |
| Academia: |
| | Please enter your current academic
status.
Example:Declared Major: Chemistry
Current GPA: 3.98/4.00
Class Rank:
96%
Verbal SAT Score: 730
Quantitative SAT Score: 780 |
| Interests and
Skills: |
| Areas of Interest: |
| | Please list the Workshop 2004 projects that
interest you most, ranked in order of preference. |
Computer Skills: |
| | Please describe your computer skills,
including languages known. |
