Request for Graduate Assistantship Application

Wichita State University

Department of Mathematics and Statistics

Wichita, Kansas 67260-0033

http://www.math.wichita.edu

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The information on this Web Site about graduate study in Mathematics and Statistics is also available as a brochure. Would you like to have this information mailed to you?

Last Name:
First Name:
Middle Name:
Maiden Name: (if applicable)
Present Mailing Address . . .
Address 1:
Address 2:
City:
State: (US only)
Province: (Canada only)
Zip/Postal Code:
Country:
Telephone:
E-Mail:
Program Requested: