Personal Information (*Required Fields) |
| *I want to be a: |
|
| *UNM ID: |
9 characters (e.g. 1********) |
| *NetID: |
This will be your login ID |
| *Create Password (used to modify information): |
|
| *Confirm Password: |
|
| *First Name: |
|
| *Last Name: |
|
| Gender: |
|
| Age: |
|
| *Ethnicity I: |
|
| Ethnicity II: |
|
| *Preferred Method of Contact: |
|
| Local Phone: |
(
)
-
|
| *Email: |
|
| *Confirm Email: |
|
| *Local Address (USPS or Department Mailbox): |
|
| *City: |
|
| *State: |
2 letter code |
| *Zip Code: |
5-digit |
| Partner Status: |
|
| Do you have children or dependents: |
|
| |
|
| |
Education |
| *Previous Education I: |
|
| Specify: |
|
| Major I: |
|
| Institution Earned from I: |
|
| Year Earned I: |
|
| Previous Education II: |
|
| Specify: |
|
| Major II: |
|
| Institution Earned From II: |
|
| Year Earned II: |
|
| *Degree you are presently seeking: |
|
| If "other", specify: |
|
| Dual Degree: |
|
| *College I: |
|
| *Program I: |
|
| College II: |
|
| Program II: |
|
| How many credit hours have you completed towards your current degree: |
|
| How many hours do you have remaining: |
|
| What are some of your research and professional interests: |
|
| |
Funding Sources |
| *What types of financial assistance have you received or will receive from UNM: |
|
| If Fellowship, please specify: |
|
| "Other" source outside UNM: |
|
| *Do you currently, or will, hold a job during the school year: |
|
| If yes, where? (specify): |
|
| What type(s) of support are you interested in: |
|
| Please list any cultural, professional, social, and/or political organizations you are, or have been, involed with: |
|
| Hobbies: |
|
| Favorite Books: |
|
| |
|
