Chemical Engineering Department

Name:
Phone(local):	Extension:
E-mail:
Address:
City:	State: Zip:
Year in School:	Cum. GPA: Credit hrs. this semester:

The number of hours you would like to work per week:
Which semester(s) do you want to work?	Fall Winter Spring Summer
When are you available to work?
When can you begin work?
Are you interested in graduate work?	Yes No

Research area(s) in which you are particularly interested?

Experience:

ChE classes taken which may help as a background for employment:

Other courses you have taken which may be helpful:

Any additional information you wish to have noted