APPENDIX A

POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY

MECHANICAL & AEROSPACE ENGINEERING DEPARTMENT

APPLICATION FOR THE

MECHANICAL ENGINEERING PROGRAM'S
Ph.D. PRELIMINARY QUALIFYING EXAMINATION

Please complete and return to the Chairman of the Ph.D. Committee (Department of
Mechanical and Aerospace Engineering, Polytechnic Institute of New York University,
Six Metrotech Center, Brooklyn, NY 11201).

NAME: _______________________________________________________________

STUDENT I.D. NO. ______________________________________________________

MAILING ADDRESS: ____________________________________________________

____________________________________________________

PHONE NUMBER: ___________________ E-MAIL: _________________________

SEMESTER ACCEPTED TO THE Ph.D. PROGRAM ___________________________

I HAVE A B. S. DEGREE IN: _____________________________________________

SCHOOL AND YEAR : _________________________________________________

I HAVE A M. S. DEGREE IN: ____________________________________________

SCHOOL AND YEAR: __________________________________________________

HAVE YOU EVER TAKEN A PH.D. QUALIFYING EXAM BEFORE (AT

POLYTECHNIC OR ELSEWHERE)? YES_____, NO_____

IF YES, LIST ALL DATES, INSTITUTIONS, SUBJECTS, AND RESULTS.

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LIST GRADUATE COURSES COMPLETED AT POLY. INCLUDE COURSE
NUMBER, TITLE, INSTRUCTOR, YEAR AND GRADE. (Attach additional sheet, if
necessary).

Course Title Instructor Year Grade

LIST COURSES CURRENTLY ENROLLED IN AT POLYTECHNIC.

Course Title Instructor Year ______

AREA OF SPECIALIZATION (Check only one)

_____A.1 Mechanical Engineering (Mechanics and Structural Systems Option)
_____A.2 Mechanical Engineering (Fluid Dynamics and Thermal Systems Option)
_____A.3 Mechanical Engineering (Controls and Dynamics Systems Option)
_____A.4 Mechanical Engineering (Aerospace Option)
_____A.5 Mechanical Engineering (Materials Option)

TOPICS OF EXAMS APPLYING FOR:

1. Mathematics

2. _____________________________

3. ________________________________

I hereby apply to take the Ph.D. Qualifying exams scheduled for __________________.

_________________________ __________________
Signature Date
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