Application Form

C-SC GENOMICS RESEARCH INITIATIVE
For Freshmen and Sophomore Students
* Required Information
* First Name:
* Last Name:
Street Address:
City:
 State: ZIP:
* Phone:
 E-Mail Address:
Gender:
 M F
High School:
 Cumulative GPA:   
ACT:    ACT Math:    ACT Science:
high school science courses:




 
If freshman:
 Have you already applied to Culver-Stockton College? Yes No
Have you been accepted for admission to Culver-Stockton College? Yes No
C-SC Student ID:
Intended Major(s):
 Biological Chemistry Biology Mathematics   Other:
Please briefly describe what biology or chemistry courses you have taken, and research experience, if any:
Please briefly describe why you are interested in the program:
Are you willing to spend extra time in lab as needed? Yes No

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