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Student Information Form Academic Services Office -Mechanical Engineering

Summary: Student Information Form
Academic Services Office - Mechanical Engineering
Today's Date 8-digit UMID #
Name (print)
Signature Line
In order to better assist you as an individual, please fill out this questionnaire. Should
your parents (other relative) wish to discuss your academic performance, this release is
Name/number to call in case of an emergency, e.g., parents, close friend

Medical conditions you wish to disclose. (e.g., diabetes)
Society and other group affiliation:
I am interested in:
International Minor
Study Abroad in ____________ term/year
Multidisciplinary Design Minor
Entrepreneurship Certificate
Energy Concentration
Manufacturing Concentration


Source: Awtar, Shorya - Department of Mechanical Engineering, University of Michigan


Collections: Engineering