Graduate Program in Molecular & Cellular Pathology

University of Alabama at Birmingham

Online Application

Instructions :

  1. Please fill out the form accurately and completely.
  2. Please do not forget to press the Submit button when finished!!
  3. All admitted students receive a full fellowship.
  4. Application is Free.

How did you find this Website?
Other:
ACADEMIC YEAR FOR WHICH YOU ARE APPLYING:
IDENTIFYING INFORMATION
FIRST NAME
 LAST NAME
M.I.
SOCIAL SECURITY NUMBER

BIRTH DATE (mm/dd/yyyy):
- -
This information is used for identification and statistical reporting only.
UAB is an equal education opportunity institution.

ETHNIC BACKGROUND: Federal law requires the University to report the ethnicity of all U.S. citizens and resident aliens in the following five categories. Please select one (or select "non-resident alien"):
GENDER: Male Female
EMAIL ADDRESS:
Previous name(s) under which transcript or other information may be found (e.g., maiden name):
CURRENT ADDRESS
CITY
 STATE
 ZIP
COUNTRY
PERMANENT ADDRESS
CITY
STATE
 ZIP
COUNTY (Alabama residents only)
COUNTRY
HOME PHONE

 WORK PHONE
PERMANENT HOME PHONE
ACADEMIC INFORMATION

DATE GRE TAKEN (OR EXPECTED TO BE TAKEN):(mm/dd/yyyy)
- (yyyy)

GRE TEST SCORES:
       Verbal:
      Quantitative:
      Analytical:

GPA (based on 4 point system):
WILL YOU HAVE LIVED IN ALABAMA FOR 12 MONTHS BY THE DATE YOU WISH TO ENROLL?
HAVE YOU PREVIOUSLY APPLIED TO THIS UNIVERSITY? Yes No
            If yes, under what status did you apply?
            If accepted, did you register? Yes No
            If you registered, under which semester could UAB locate your records?
             (example: Fall, 1998)
HAVE YOU EVER BEEN SUSPENDED, DISMISSED FROM, OR
ENCOURAGED TO LEAVE ANY COLLEGE OR UNIVERSITY OR ADVANCED PROGRAM? Yes No
If yes, explain in detail:
ACADEMIC HISTORY
NAME OF INSTITUTION STATE DATES ATTENDED DEGREE AND
MAJOR 		DATE AWARDED OR EXPECTED
LETTERS OF REFERENCE
REFERENCE
{FIRST AND LAST NAME} 		ADDRESS TELEPHONE NUMBER
CITIZENSHIP AND RESIDENCY INFORMATION
NATION OF CITIZENSHIP
 COUNTRY OF BIRTH

If you are not a U.S. Citizen but you have U.S. Permanent Residency status, Please give your Alien Registration Card number:

TOEFL INFORMATION
If your native language is not English, you must provide us with your score on the Test Of English as a Foreign Language (TOEFL) with TWE.
Official TOEFL Score Reports must be sent by the Testing Service directly to the UAB Graduate Program in Molecular & Cellular Pathology at address at end of page.
DATE TOEFL WAS/WILL BE TAKEN: SCORES (For our advance information):
VISA INFORMATION
(This section for non-U.S. citizens ONLY)
If you are currently in the U.S., what type of visa do you hold?
 Please choose your visa preference:
If you are currently studying in the U.S., which institution are you attending?
CAREER AND GOALS STATEMENT
It is very important that you use the space below to provide a brief summary of your career goals and research experience. Please feel encouraged to include any other information that you believe would improve your chances for admission.
SIGNATURE

I certify that the information provided on this application and supplemental documents is true and accurate to the best of my knowledge. I understand that omissions or falsifications may result in withdrawal of a decision to accept me. I further understand that I must request and provide official transcripts from all previous colleges or universities attended before I may be admitted to a degree program.

Full Legal Name:


Today's Date:

The University of Alabama at Birmingham does not discriminate on the basis of sex, race, religion, color, national origin, Vietnam Era veterans' status or handicapping condition in its admissions, employment and educational programs or activities. Inquiries may be referred to UAB Human Resource Management, 1717 11th Avenue South, Birmingham, Alabama 35294-4410.
FINAL INFORMATION

Please read before clicking the Submit button!

  1. Please check this form carefully to make sure that it is complete, and that all questions have been answered accurately.
  2. Please print a copy for your records.
  3. Send official GRE and TOEFL results to the University of Alabama at Birmingham, Department of Pathology. The TOEFL Department code is 56. The GRE Department code is 215.
  4. You must have THREE signed letters of recommendation, on official letterhead, written by people who know your academic abilities. These letters should be mailed to:
    UAB Department of Pathology
    Division of Molecular and Cellular Pathology Graduate Program
    c/o Scott Ballinger, Ph.D. and Theresa Henson
    Volker Hall G019
    1530 3rd Avenue South
    Birmingham, AL 35294-0019
  5. Have your official college transcripts, official GRE results and TOEFL results forwarded to the address above.
  6. When you are certain that the form is complete, please click the Submit button below. Do not click the button more than once.

    Graduate Program in Molecular and Cellular Pathology