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Name: Date: PID: Email address: Major: Class Rank (freshman, sophomore etc): GPA as of last DARS (freshman please use NA): What are your main areas of interest in biology and potential research / career goals?: Research experience, if any, to date: Potential reference (person who would put in a good word for you): Name: Title: email address: phone: Submit to Professor Willem Roosenburg by email Email:  HYPERLINK "mailto:roosenbu@ohio.edu" roosenbu@ohio.edu /016;<C^_`frs|¶ª˜xh[N<"h?D1hB56B*CJ H*phhB56B*CJ phhU56B*CJ phh]bh]b56B*CJ phh<h]b5:CJ aJ #h<h]b5:B*CJ aJ ph#h<hM5:B*CJ aJ phh<5:CJ ]aJ h<5:CJ ]aJ h<h<5:CJ ]aJ hj\T5:CJ hj\Thj\T5:CJ hj\Th(5:CJ jhUmHnHu1`s6 7    " ' = > E F l m gdYRgd?D1$a$gdj\T$a$gd<$a$gd(    4 5 6 7 8 9 D Z ^ _ k x     ɺɣɜhj\Th(5 h?D15 h<h?D1h?D1h?D15\hBh&J`h?D10J h?D1h?D1jh?D1Uh?D1h]bh/56B*CJ ph h?D15CJ h56B*CJ phh?D156B*CJ H*ph6  ! 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