On-line Application Form

Interdepartmental Neuroscience Graduate Program

Please note the application deadline for Fall entry is January 15th.

The Neuroscience Program and Iowa State University are committed to the concept and practice of affirmative action and do not discriminate on the basis of age, color, creed, handicap, national origin, race, religion, sex, or any other classification that deprives the person of consideration as an individual.

First Name

Last (Family) Name

Address

Country of Citizenship

Ethnicity

E-mail

Telephone

Fax

Degree Sought

Note: an M.S. is not a prerequisite for a Ph.D.

Desired Starting Date

Educational Background:

Institution	Country	Degree Earned	Major	Graduation Date
Example: Univ. of Iowa	USA	BS	Biology	5/98

Grade Point Averages:
B.S./B.A. on a scale of (in Major ); Class Rank (if available)
M.S./M.A. on a scale of (in Major ); Class Rank (if available)

Test Scores:
GRE General Test:
Verbal Score Percentile
Quantitative Score Percentile
Analytical Score Percentile
Total

GRE Subject Test:
Subject , Score , Percentile

TOEFL Score

Note: both GRE and TOEFL scores are required for international applicants.

References: Please ask three individuals familiar with your qualifications to send letters of recommendation directly to the postal address at the bottom of this form. Please list your references below. Please have your references use their own letterhead stationery.

Please provide a brief description of your research interests. (Limit 300 characters)

If there are any individual Neuroscience faculty whose research particularly interests you, please list their names here:

Note: all offers of admission and financial support are contingent on formal application and admission to the Iowa State University Graduate College. Applicants are instructed to apply to the Graduate College only upon receipt of a formal offer of admission from the department. Do not apply to the Graduate College unless instructed to do so by the department.

The Neuroscience program encourages you to communicate with us as to the status of your application at any time. As you have questions about the program, about the university, or about the admissions process, please email, write or phone.

Interdepartmental Graduate Program in Neuroscience
2018 Molecular Biology Building
Iowa State University
Ames, IA 50011-3260
USA

Telephone: 515-294-7252
Fax: 515-294-6790
E-mail:

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