| Name: | |
| Address: |
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| Email: | |
| UM standing: | Incoming Freshman Sophomore Junior |
| UM C# (if you have one): | |
| First major: | |
| Second major (select one): | Computer Science Mathematics |
| Prior coursework or preparation in Computer Science of Mathematics: | |
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| Ethnicity (select one): | Hispanic/Latino Not Hispanic/Latino |
| Sex (select one): | Female Male |
| Race (select one): | American-Indian/Alaska-Native Asian
Black/African-American Native-Hawiian/Pacific-Islander White |
| Submission of ethnicity, sex, and race information is voluntary, and is not a precondition of award. | |