department of computer science southern univerrsity raytheon … · 2018. 6. 21. · disclaime...

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Disclaime (Summer Last Nam Telephon Major: __ Expected Classificat List specia clubs, org which you ________ ________ ________ Most pos that woul Select one ________ ________ ________ I give perm records. (S Signature er: Being selec Intern, Co-op e: _________ e: _________ ____________ Graduation D tion: (Select o al academic h ganizations, e u have partic ____________ ____________ ____________ itions at Rayt ld prevent yo e: ____________ ____________ ____________ mission to the Sign by initial e of Applicant Dep Raytheo cted to partici p, or Full time) ___________ ___________ ___________ Date: ______ one) honors, speci extracurricula cipated: ___________ ___________ ___________ theon require ou from gettin ___________ ___________ ___________ e Department ling below) t: _______ partment o Southe on Mentor ipate in the M ) with Raythe ___________ ____________ ___ Degree: ____________ ial recognitio ar activities a ____________ ____________ ____________ e a Departme ng a clearanc ____________ ____________ ____________ t of Compute of Comput ern Univer ring Progra Mentoring Pr o eon Company First Name: __ Email: ___________ _______ on, scholarshi nd communi ___________ ___________ ___________ ent of Defens ce? (If your an ___________ ___________ ___________ r Science Com ter Science rsity am Applica ogram does n y : __________ __________ ___________ ips, and/or a w ty activities a ___________ ___________ ___________ se security cl nswer is 'Yes ___________ ___________ ___________ mmittee to re e ation not guarantee ____________ ____________ _______ Over wards you ha and commun ____________ ____________ ____________ earance. Is th s', please exp ____________ ____________ ____________ view all of my e a position _______ MI: ___________ rall GPA: ___ ave received; nity activities ___________ ___________ ___________ here anythin g lain) ___________ ___________ ___________ y academic ____ _____ _____ ; in _____ _____ _____ g _____ _____ _____ Freshman Sophomore Junior Senior Yes (Please Explain) No

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Page 1: Department of Computer Science Southern Univerrsity Raytheon … · 2018. 6. 21. · Disclaime (Summer Last Nam Telephon Major: __ Expected Classificat List specia clubs, org which

Disclaime

(Summer

Last Nam

Telephon

Major: __

Expected

Classificat

List specia

clubs, org

which you

________

________

________

Most pos

that woul

Select one

________

________

________

I give perm

records. (S

Signature

er: Being selec

Intern, Co-op

e: _________

e: _________

____________

Graduation D

tion: (Select o

al academic h

ganizations, e

u have partic

____________

____________

____________

itions at Rayt

ld prevent yo

e:

____________

____________

____________

mission to the

Sign by initial

e of Applicant

Dep

Raytheo

cted to partici

p, or Full time)

___________

___________

___________

Date: ______

one)

honors, speci

extracurricula

cipated:

___________

___________

___________

theon require

ou from gettin

___________

___________

___________

e Department

ling below)

t: _______

partment o

Southe

on Mentor

ipate in the M

) with Raythe

___________

____________

___ Degree:

____________

ial recognitio

ar activities a

____________

____________

____________

e a Departme

ng a clearanc

____________

____________

____________

t of Compute

of Comput

ern Univer

ring Progra

Mentoring Pr o

eon Company

First Name:

__ Email:

___________

_______

on, scholarshi

nd communi

___________

___________

___________

ent of Defens

ce? (If your an

___________

___________

___________

r Science Com

ter Science

rsity

am Applica

ogram does n

y

: __________

__________

___________

ips, and/or aw

ty activities a

___________

___________

___________

se security cl

nswer is 'Yes

___________

___________

___________

mmittee to re

e

ation

not guarantee

____________

____________

_______ Over

wards you ha

and commun

____________

____________

____________

earance. Is th

s', please exp

____________

____________

____________

view all of my

e a position

_______ MI:

___________

rall GPA: ___

ave received;

nity activities

___________

___________

___________

here anythin g

lain)

___________

___________

___________

y academic

____

_____

_____

;

in

_____

_____

_____

g

_____

_____

_____

Freshman Sophomore Junior Senior

Yes (Please Explain) No

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