CAEP Prequalifier Request Form

1.      Name (last, first):
Mailing address:  

2.      UTEID:

3.      Education: (Year graduated and Institution)


4.      Record in UT Grad School:
Semester of first enrollment:  
Graduate credit hours completed:          current GPA:  

List all UT faculty that have supervised you and for what (EE 397, thesis, RA, TA, etc.):

5.      Ph. D advisor if any:

6.      Coursework: Please list all courses that you have taken or are currently taking as a graduate student at UT-ECE.

Course #

Course Name



7. List your topics of interest  (eg: Computer Architecture, Programming languages, Compilers, Operating Systems, Digital Design, Embedded Systems, VLSI, Parallel Processing, Computer Arithmetic. Alternately you may list courses of interest, eg: EE460N, EE319K, EE316,  EE445L, ………)

8.      Declaration: I hereby attest that the information provided by me in this form is complete and correct to the best of my knowledge. I understand that misrepresentation or withholding of information asked is grounds for penalizing action that may include suspension from the ECE graduate program.


Drop hard copy of the signed form to Dr. Lizy John’s office, ACES (POB) 3.114