McNair Questionnaire Form

Graduate Tracking Form

The McNair Program is required by the U.S. Department of Education to track all program participants for a period of time necessary to complete a doctoral program of study. Therefore, please inform the McNair Program if your "current" or "permanent" address or phone number has changed. In addition, you must complete the Graduate School Status and Financial Assistance sections below in order for us to comply with our program's objectives.

Name :

Date :

Current Contact Information :

Mailing Address :

City :

State :

Zip Code :

Area Code :		Phone No :

Email :

Permanent Contact Information :

Mailing Address :

City :

State :

Zip Code :

Area Code :		Phone No :

Email :

Professional Employment Status :

Employer :

Position :

City :

State :

Zip Code :

Area Code :		Phone No :

Part Time :

Full Time :

IF YOU ARE ENROLLED IN GRADUATE SCHOOL, PLEASE COMPLETE BOTH GRADUATE SECTIONS BELOW.

Graduate School Status :

Name of Institution :

Name of Program (Major) :

Degree Sought :

Status :	Part - Time
	Full - Time

Expected Graduation Date :

Current GPA :

Year in School :	First Year
	Second Year
	Third Year
	Fourth Year
	Fifth Year
	Sixth Year

Graduate School Financial Assistance:

Type of Financial Assistance :	GA TA RA Fellowship Loan None

Other :

Amount Awarded	$

School Employment position :

Status :	Part Time
	Full Time

Date you plan to enroll in Graduate School :

	Fall
	Spring
	Will Not Enroll

University :

Program of Study


This page is maintained by CalState Fullerton McNair Scholars Program. Report problems to gbryant@fullerton.edu. California State University, Fullerton ©2002. All Rights Reserved.

Graduate Tracking Form

This page is maintained by CalState Fullerton McNair Scholars Program. Report problems to gbryant@fullerton.edu. California State University, Fullerton ©2002. All Rights Reserved.