Teaching/Research Fellowship and Graduate Assistantship Interest Identification Form
Office of Graduate Admissions
263 Alden Street Springfield, MA 01109-3797
Last Name:
First Name:
Middle Initial:
Social Security Number:
Mailing Address:
Street:
City/Town:
State
Choose one
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Washington D.C.
Zip Code:
Telephone:
Home
School or Business
E-mail:
Fax:
Fellowships:
Please identify all fellowships in which you are interested and feel qualified for. Those marked with an asterisk (*) require Departmental Fellowship Application Forms, which will be forwarded to you upon the return of this Interest Identification Form.
Academic Advising*
PE/Physical Education Skills*
Art Therapy*
PE/Recreation/Outdoor/Therapeutic*
Biology/Chemistry*
PE/Research/Statistics
Computer Science*
PE/Soccer*
Counseling Center/Alcohol & Substance Abuse
PE/Softball*
Education*
PE/Sport Management*
Graduate Admissions*
PE/Sport Psychology*
Graduate School Office*
PE/Tennis*
PE/Tests and Measurements*
Mathematics*
PE/Track and Field*
Multicultural Student Affairs*
PE/Volleyball*
Occupational Therapy*
PE/Wellness Center*
PE/Aerobic Dance
PE/Wrestling*
PE/Applied Exe. Sci./Strength & Conditioning/Wellness Ctr.*
Physical Science/Physics*
PE/Aquatics*
Physical Therapy
PE/Athletic Administration*
Psychology*
PE/Athletic Training*
Rehabilitation Counseling and Services*
PE/Baseball*
Residence Life*
PE/Club Sports*
Social Sciences*
PE/Elementary Secondary Physical Education/Methods*
Social Work*
PE/Exercise Physiology/Biomechanics*
Student Activities
PE/Field Hockey*
Student Affairs
PE/Gymnastics*
Student Health Center
PE/Health Studies/Health Promotion and Wellness*
Student Volunteer Programs
PE/Lacrosse*
Teacher Preparation & Certification*
PE/Outdoor Pursuits*
Undergraduate Admissions
PE/Outdoor Recreation (East Campus)*
***
PE
/
Club Sports
:
Crew
/
Cross Country
/
Rugby
/
Skiing
/
Hockey
/
Rugby
*
Graduate Assistantships:
Please identify all assistantships in which you are interested and feel qualified for.
Alumni Fund/Development
Alumni Affairs
Career Services
Financial Aid
Library Services
Date Submitted (EST):
11/21/2009 05:34 PM