FOR OFFICE USE ONLY:

Date Received: _____________

Fee Received: _____________
ID #: _____________

Lincoln Memorial University

Master of Science (MS) Application

A non-refundable application fee of $50 must accompany all applications for graduate studies. Application,
fee, and official transcripts from all attended institutions must be returned to the MS Office of Admissions,
MANS 324, Lincoln Memorial University, 6965 Cumberland Gap Parkway, Harrogate, TN 37752.
Please print or type.

Jin-Hao
Chang
Name _________________________________________________________
SS# _____________________________
Last

First

Maiden/Middle

8788 Golden Street

Mailing Address _________________________________________________________________________________
Street

Rancho Cucamonga
California
91701
____________________________________________________________
City

State

USA
County _________________

Sex: Male ________ Female _________

Zip

April 26, 1993

Date of Birth ___________________

Race ____________________
Voluntary reporting purposes only

231-8901
231-8901 (909)
Telephone (909)
___________________
___________________
Work

alex-jhc@berkeley.edu
E-Mail __________________________

Home

Are you a US citizen or permanent resident of the US? _________ Yes

_________ No

If you answered no, please provide your country of birth and country of citizenship.
__________________________________________________________________________________________
Desired semester of entry: __Fall, 20________________
15
Proposed Major:
Biomedical Professions with Medical School Emphasis

__________

Biomedical Professions with Veterinary School Emphasis

__________

Anatomical Sciences

__________

Life Science Research

__________

Life Science Teaching

__________

Housing Plans:

LMU Graduate Housing ___________

Off Campus Housing ___________

List ALL colleges or universities attended (include LMU). The applicant must submit official transcripts
from each school attended. These may be sent directly to the Master of Science Office of Admissions.
Name of Institution

Location

University
Univ
of Cal, Berkeley

Dates Attended

Berkeley, CA

Major

Aug 2011-May 2015

Degree

Integrative Biology

BA of Integrative Biology

Additional Academic & Confidential Information

Are you currently on probation, parole, under court restriction, or have you ever been convicted of a felony
other than a minor traffic violation? _____________ ______________
Yes
No
If yes, please explain:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Were you ever the recipient of any action for unacceptable academic performance (including but not limited
to academic probation or academic warning) or were you ever the recipient of any action for conduct violations at any school?
_____________
______________
Yes
If yes, were you ever denied admission?

No
____________
Yes

_____________
No

I hereby certify that the information given on this application is complete and accurate.
_________________________________________________

Signature

Date

_________________________________________________

Master of Science Admissions Committee

APPROVED FOR GRADUATE STUDY:

________________

_________________

_______________

Major

Date

________________________________________

______________

Dean, School of Mathematics & Sciences

Date