Pre-MAP Information Form

If you are interested in joining Pre-MAP, please fill out the form below and we'll contact you with more information about the program as the school year approaches.

Name:
Email address:
Phone Number:
High School:
City, State:
Ethnic/Cultural Group with which
you identify the most (i.e. ethnicity):
Gender:
Do you know what you'd
like to major in at the UW?		 Yes
No
If yes, what is your intended major?
Any other pertinent information:
Where did you hear about us?:
     University of Washington Department of Astronomy