Student Application for CSMAP
(Computer Science Major Accessibility Project)
Name: ____________________________________                                             Date: ___________

Address:  __________________________________                  Email: _______________________
                __________________________________                 Phone:  _______________________

Major(s): _______________________________________   Minor: __________________________

Number of credits taking in Fall? _____   Spring? _____   Expected graduation date: ____________

Can you work 10-15 hours a week during school?  ____________
Can you work summers (up to 20 hours a week)?   ____________

List all CS courses you have taken or attempted.
Course #   Name                                        Term               Grade                    Instructor                 Repeat?   
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List other CS or special skills you have.
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List other activities (sports, jobs, etc.) you are involved in and amount of time per week.
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Give two Faculty References:
1. ______________________________________      2. ______________________________________
 

List any additional information you would like to provide below or on the back of this sheet.
 
 
 
 
 
 
 

Attach a copy of your transcript and turn in to the Computer Science office.