Scholars Update

RONALD MCNAIR POST BACCALAUREATE ACHIEVEMENT PROGRAM

EAST TENNESSEE STATE UNIVERSITY

MCNAIR SCHOLAR UPDATE FORM

Each year the U.S. Department of Education requires all McNair Programs to produce an annual report. The Department wishes to know if the program has been successful in assisting students with entry into graduate programs. Continued funding of the program is contingent upon the completion of this report. Your cooperation is greatly appreciated. ALL INFORMATION WILL REMAIN CONFIDENTIAL.

Section 1: Current Contact Information

FIRST NAME:

LAST NAME:

MI:

MAIDEN NAME: (if applicable)

CURRENT ADDRESS:

Street:

City:

State:

Zip:

Current E-mail

HOME PHONE: - CELL PHONE: -

MAIL ADDRESS:

Section 2: Permanent Contact Information

Check box if same as above

Street:

City:

State:

Zip:

HOME PHONE: -

If you are enrolled in a graduate program, please complete both graduate sections below. If you are still an undergraduate proceed to section 5.

Section 3: Graduate School Status

NAME OF INSTITUTION:

NAME OF PROGRAM (MAJOR):

DEGREE SOUGHT:

STATUS: Part-time Full-time

EXPECTED GRADUATION DATE:

CURRENT GPA:

YEAR IN GRADUATE SCHOOL: First Second Third or beyond

Section 4: Graduate School Financial Assistance

TYPE OF FINANCIAL ASSISTANCE:

GA	RA	Loan	None
TA	Fellowship	Scholarship	Other

AMOUNT AWARDED:

SCHOOL EMPLOYMENT POSITION:

EMPLOYMENT STATUS: Part-time Full-time

If you are currently enrolled in a graduate program you may skip section 5 and proceed to section 6.

Section 5: Plans for Graduate School

DATE THAT YOU PLAN TO ENROLL IN GRADUATE SCHOOL:

Fall Spring Year

Not planning to enroll Already enrolled (please complete sections 3 and 4)

Not sure

If you are not planning to enroll or withdrew from a graduate program, please check one of the following reasons:

Applied but did not gain admission	Did not apply or declined offers due to financial reasons
Did not apply or declined offers for health reasons	Did not apply or declined offers for other reasons
Withdrew from program for academic reasons	Withdrew from program for financial reasons
Withdrew from program for health reasons	Withdrew from program for other reasons

If you do plan to enroll:

WHERE WILL YOU ENROLL?

WHAT PROGRAM OF STUDY?

WHAT DEGREE WILL YOU SEEK?

Section 6: Professional Employment Status

CURRENT EMPLOYER:

POSITION:

CITY:

STATE:

EMPLOYMENT STATUS: Part-time Full-time

Section 7: Previous Educational Experience

PLEASE PLACE A CHECK BESIDE ANY DEGREE(S) THAT YOU HAVE ALREADY EARNED:

Associates	Bachelors	Masters	PhD	EdD
J.D (Law)	PharmD	M.D.	PsyD	Other

DATE(S) THAT YOU RECEIVED YOUR DEGREE(S) :

Month	Year	Degree
Month	Year	Degree
Month	Year	Degree

IF YOU HAVE GRADUATED WITH YOUR BACHELOR’S DEGREE, PLEASE ANSWER THE REMAINING QUESTIONS IN THIS SECTION.

WHAT WAS YOUR CUMULATIVE GPA WHEN YOU GRADUATED?

WHAT WAS THE GRADING SCALE?

4 point scale 5 point scale

Section 8: Needed Assistance

DO YOU HAVE ANY NEEDS THAT THE ETSU MCNAIR PROGRAM COULD HELP MEET?

THANK YOU!