Gates Cambridge Scholarship Declaration of Interest Form
Please complete this form as a first step if you are interested in working with CUSE on an application for the Gates Cambridge Scholarship.

After you submit this form, please submit a resume or vita via email to fellows@nd.edu with the subject line "Gates Interest Form Resume - [Your Last Name, Your First Name]".

You should then visit cuse.nd.edu/gates for more information about your next steps.

First Name
Your answer
Last Name
Your answer
9-Digit University ID Number
Your answer
Email
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Grad Year
Your answer
Current Cumulative GPA
Your answer
Hometown
Your answer
Primary College/School
Secondary College/School (if applicable)
Major 1
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
Scholars/Honors Group Membership (if applicable)
Check all that apply. Complete the "Other" line if you are a member of a scholars/honors program not listed here.
Current/Completed Study Abroad (if applicable)
Please indicate program and semester(s). Separate multiple programs with a semicolon. (Example: London, Summer 2015; Rome, Fall 2016)
Your answer
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