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.

* indicates a required field.

       
* First Name  
* Last Name  
* Date  

Current Contact Information


* Address  
* City  
* State  
* Zip Code  
* Phone (with area code)  
* Email  

Permanent Contact Information


Please fill out if NOT same as above.

  Address  
  City  
  State  
  Zip Code  
  Phone (with area code)  
  Email  



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 or Date Degree Earned  
  Current GPA  
  Year in School  

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
Already Enrolled
Not Sure
 
  When do you plan on enrolling?  
  University  
  Program of Study  

Professional Employment Status


  Employer  
  Position  
  City  
  State  
  Zip Code  
  Phone (with area code)  
  Status Part / Time
Full / Time