Museum Studies Certificate Intake Form
Museum Studies Program, 77 E Main Street, Newark DE 19711   (302) 831-1251
Kenneth Cohen, Program Director         cohenk@udel.edu

IMPORTANT!  To apply for admission to the program, please complete this form and set a meeting with Ken Cohen.

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Name *
Student ID *
Preferred Pronouns *
Local (Campus) Address (Include city,state,zip) *
Permanent (Home) Address (Include city,state,zip) *
Phone *
UDel Email Address *
Personal Email Address *
UD Program and Department you are entering. *
Advisor *
University Enrollment Year *
Expected Graduation Date *
Prior Education- Institution, Degree(s)/Mahor(s) & Completion Dates *
Area of Special Interest? (Coloniel history, historic preservation, music education, national parks, etc)
Internship Locations of Interest (e.g. Local, Philadelphia, Atlanta, Chicago, etc)
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