MARC U*STAR Application

Name Name First Last
Panther ID
Phone Phone - ### - ### ####
Gender
Date of birth Date of birth / MM / DD YYYY
Status

Status U.S. Citizen Resident
If Resident: Alien #
Current Mailing Address Current Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Ethnicity

Ethnicity Alaska Native American Indian Asian Black Hispanic Pacific Islander White Other Other
FIU Email
Secondary Email
Academic Information
Current Major
Second Major
Minor
Expected Graduation Date Expected Graduation Date / MM / DD YYYY
Graduate Professional Interest
GPA
Current Academic Year

Current Academic Year Freshman Sophomore Junior Senior
Degree Objectives

Degree Objectives Ph.D. M.D. Combined M.D. & Ph.D. Other Other
Please submit your Statement of Purpose

Attach Files
Please submit your Official Transcripts (FIU transcripts may be unofficial)

Attach Files
Please submit your Resume or CV

Attach Files