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a. I am: Male Female
b. By June 30th of this year, I will be: 18 or under 19-22 years 23-26 years 27-30 years over 30
c. I will graduate/have graduated: (year and quarter)
d. My overall grade-point average is: 2.0-2.49 2.5-2.99 3.0-3.49 over 3.5
e. I entered the Physiological Science department as: freshman (started UCLA as a Phy Sci major) direct transfer from (name of school) I changed my UCLA major from
f. Why did you choose this department for your major? Were your expectations for the major met?
a. How would you rate your overall education in the department? [Excellent] 1 2 3 4 5 [Very Poor]
Comments:
b. What suggestions and comments would you make to the faculty regarding the curriculum (e.g. changes in departmental requirements, improvement in courses, overlaps or omissions in curriculum content)?
1. Non-departmental preparation courses (Life Science Core Curriculum):
2. Required courses
PS 107
PS 111A
PS 111B
PS 111C
PS 111L
3. Elective courses (please list them)
4. Other comments on the department curriculum
c. Did you participate in research and if so. Please note the number of SRP and/or 199 course completed and with whom.
SRP 199 198ABC
Name(s) of research mentor
Please comment on the value of your research experience:
a. How often have you been to the Undergraduate Counselor for advising or related services, on the average?: never once per year once per quarter more than once per quarter
b. What services/information did you find most helpful?
c. What services/information not presently offered would help contribute to your academic career (please be specific)?
What are your career/educational plans for the next year? For the next 5 years?