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1402 SC, College of Engineering, The University of Iowa, Iowa City, Iowa, 52242-1595 USA
Phone: (319) 335-5632 Fax: (319) 335-5631

Pre-Application for Graduate Study

Contact Information
Name _________________________ E-mail address _________________________
Mailing Address ________________________________________________________
______________________________________________________________________
Academic Information
Name of Undergraduate School ___________________________________________
Text
Undergraduate Major ___________________ Graduation Date __________________
Language of instruction at your school _______________________________________
Undergraduate GPA on the basis of 4.0 (A = 4.00) _____
If percent score was used in your school, please list here _____
Class rank (i.e. Top 10%) _____
Analytical
GRE Scores: Quantitative _____ Verbal _____ _____
TOEFL Score (if applicable): _____
Text Field
Name of graduate school (if applicable): _____________________________________
Graduate School Major (if applicable): _______________________________________
Graduate School GPA (if applicable): ________________________________________

Focus Area
Ph
Degree Objective at The University of Iowa (select one): MS D
Please indicate an area of academic interest:

Indicate a specific area of research interest: __________________________________

______________________________________________________________________

Financial Aid
Do you have financial support (Approximately $11,000 US Dollars per year) to attend
this University? Yes No
Do you plan to apply for financial support in the form of a graduate assistantship or part-
time employment? Yes No

To the best of my knowledge, all of the above information is correct

Name ________________________________ Date ______________________
The University of Iowa requests this information for the purpose of screening graduate applicants. No persons outside the University
are routinely provided this information. All requested information is required. If you fail to provide the required information, The
University may not process your request for application.