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GRADUATE STUDIES

ADDITIONAL INFORMATION FORM


FACULTY OF ENGINEERING AND APPLIED SCIENCE
Instructions to the Applicant

THIS FORM SHOULD BE COMPLETED AND MAILED TO:


SCHOOL OF GRADUATE STUDIES,
MEMORIAL UNIVERSITY OF NEWFOUNDLAND,
ST. JOHN'S, NEWFOUNDLAND,
CANADA, A1C 5S7.
Applications should be complete with the names and addresses of two referees and certified copies of transcripts showing the marks or
grades in each course of the undergraduate degree program. Incomplete applications will not be considered.

1. Name in Full - Mr./Mrs./Miss/Ms.:

2. Address for reply:

3. Email Address: ____________________________

4. Telephone Number: 5. Date of Birth: _________

6. Citizenship:
G Canadian Citizen / Permanent Resident of Canada
G Student Visa of (specify the country)
7. Education:

Universities Dates of Major Field Degree Division or Rank in


Attended Attendance of Study Received Class and the
% Mark Class *
From To Received

NOTE: *Please specify the number of students in the class when you indicate rank. Ranking (example 3 of 20)
8. Language of University Education: ____________________

9. Degree for which you wish to apply? (Check one only.)

G M.Eng G Ph.D (Research Based)

  Civil Engineering
 Electrical Engineering
 Computer Engineering
  Mechanical Engineering
  Ocean and Naval Architectural Engineering
 Oil & Gas Engineering

G M.A.Sc. (Course-Based)

 Computer Engineering
 Environmental Systems Engineering & Management
 Oil & Gas Engineering

G Master of Engineering Management (Course-Based)

10.
G Full time
G Part time (M.Eng. and Ph.D. only)

11. Proposed Starting Date:


G September
G January G May__, 20_
(M.Eng. and Ph.D. only)

12. Within the above disciplines it is possible to work in a number of different


areas. Please list below the areas of your interests.
13. List briefly (starting from the present job) professional and/or industrial
experience that you have had. (Attach an additional sheet if necessary.)

Name of Organization Title/Designation Period Type of Work

14. Please make a specific statement of your research interests and objectives.
This statement should include research you have done, papers published and what
you hope to achieve at Memorial University. Further, the statement should include
your objectives after completion of Graduate Study.

Signed Dated ________________________

Memorial University protects your privacy and maintains the confidentiality of personal information. The information
requested on this form is collected under the authority of the Memorial University Act (RSNL 1990 Chapter M-7). The
information collected is to be used in circumstances where there is a need to contact you or forward items to you. If
you have any questions concerning the collection and use of this personal information, please contact Associate Dean,
(Graduate Studies) at 709-737-8900.

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