Student Name
901#
Phone Number (304-555-5555)
Email Address
Semester(s) and year the project will be carried out:
Major ... Biology Cell, Molecular and Medical Biology Ecology and Evolutionary Biology Microbiology
Expected Graduation Date Semester Year ... Spring Summer Fall ... 2012 2013 2014 2015 2016 2017 2018 2019 2020
Clinical Mentor
Mentor's Profession
Mentor's Address
Mentor's Phone Number (304-555-5555)
In the space below, describe the shadowing plan you and your mentor have agreed upon. Include all unique features of the project and how these opportunities will benefit your academic experience. Once you have received notification that the Department of Biological Sciences has ganted your proposal preliminary approval, have your Clinical Mentor sign the printed notification received in the approval email. You must submit the signed notification to Dr. David Mallory (S 350) to pick up the necessary paperwork to register for BSC 491.
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