APPLICATION FORM INDUSTRIAL CHEMISTRY MAJOR - 2023/2024
Student ID Number
*
Name
*
FIRST NAME
SURNAME
MAJOR(S)
*
MINOR(S)
Phone Number
*
Please enter a valid phone number.
Other Number
Please enter a valid phone number.
EMAIL
*
john.doe@my.uwi.edu
COURSES THAT YOU ARE CURRENTLY PURSUING AND/OR PURSUED PLEASE LIST GRADES OBTAINED:
*
Grade
Mark
CHEM 2170
CHEM 2270
CHEM 2370
CHEM 2470
CHEM 2672
CHEM 2673
CHEM 3170
CHEM 3270
CHEM 3370
Additional Courses
Course
Grade
Mark
1
2
3
Reason (s) for requesting MAJOR in Industrial Chemistry
PREVIOUS WORK EXPERIENCE
Company/Institution
PERIOD WORKED
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