CUSE National Fellowships Intake Form
Before working with CUSE National Fellowships, we request that you complete this intake form in order to help us prepare for the initial meeting. After you have completed the form, please return to http://cuse.nd.edu/fellowships/make-an-appointment/ and follow steps 2 and 3 under "If this is your first time meeting...."

Please direct questions to fellows@nd.edu.

First Name
Your answer
Last Name
Your answer
NDID (if applicable)
Your answer
Email
Your answer
Graduation Year (actual or expected)
Your answer
Primary College/School
Secondary College/School (if applicable)
Major 1
(Type "undecided" if applicable.)
Your answer
Major 2 (if applicable)
Your answer
Major 3 (if applicable)
Your answer
Minor 1 (if applicable)
Your answer
Minor 2 (if applicable)
Your answer
Minor 3 (if applicable)
Your answer
Current Cumulative GPA
Your answer
How did you hear about CUSE National Fellowships?
(check all that apply)
If there are specific fellowships in which you are interested at this time, please check the appropriate boxes.
See http://cuse.nd.edu/fellowships/fellowships for more information about certain awards. See for our Fellowships Flowchart (PDF).
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