UNIVERSITY OF HAWAI`I AT MANOA
INTERDISCIPLINARY CIS PH.D. PROGRAM
EXPRESS INFORMATION FORM

Please submit to the address below as soon as possible.

Name:

______________________________________________________________________
  Last      First      Middle

Address:

______________________________________________________________________
  Street

______________________________________________________________________
  City                 State/Province

______________________________________________________________________
  Country              Postal Code


Telephone: ____________________________ Fax: _____________________________

Citizenship: __________________________ Email: ____________________________

When will you mail your complete application? ___________________________________

GRE/GMAT Score(s)

Verbal __________  Quantitative _________   Analytical ______________

(If not yet taken, when will you take it?) _________________________


Masters Degree:

School:________________________________ Date received: _____________________

Field: _________________________________________________________________

Grade Point Average: ____________ or Position in Graduating Class _______ of _______

TOEFL Score (if not a native speaker of English): ________

How did you find out about our program?

Signature: ______________________________________ Date: ________________

Print and send to the following address, or send an electronically edited verison to cis-chair (at) lists . hawaii . edu

Communication and Information Sciences PhD Program
University of Hawaii at Manoa
Hamilton Library 002C
2550 McCarthy Mall
Honolulu, Hawaii 96822
USA