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Enrollment Form (please read info on enrollment)

please print, fill out and mail to:
Jolanda van Vliet-Noble
GeoEngineering Centre at Queen's - RMC
Ellis Hall, room 105b
Queen's University

Family Name: __________________ Given Name: _________________

Email address: ________________________Phone: 613 533-________

Home Department: ______________

Student # ______________________

Research Supervisor(s): ______________________________________

Degree of study:MSc/PhD/Other _______

Term and Year of first enrollment: __________

GeoEngineering Graduate Course taken (or to be taken) in home
department: _______________________

GeoEngineering Graduate Course taken (or to be taken) outside home department: _________________

Expected date of degree completion:
____Winter/Spring _________________________________________

Thesis title:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

Area(s) of research focus:

___ Geotechnical Engineering ___ Geoenvironmental Engineering
___ Geomechanics ___ Geosynthetics ___ Geochemistry ___ Hydrogeology

Other Issues (for retroactive consideration of ongoing students)
__________________________________________________________
__________________________________________________________


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