Cubicle Application Form
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ELECTRICAL ENGINEERING DEPARTMENT
The Henry Samueli School of Engineering and Applied Science
University of California, Los Angeles
CUBICLE APPLICATION FORM
The Department has two rooms with a total of 149 cubicles for graduate students. Students may apply for a cubicle by sending an
email to Mr. Gershwin Mason III (gmason@ee.ucla.edu) with the information listed below or submitting this form. Please note that
cubicles are assigned only to students who are actively involved in research with an EE faculty member.
1. Student Name:_________________________ Date: _________ UID#:_______________________
2. Email Address:__________________________Advisor:____________________________________
3. Date first enrolled as EE graduate student: month/year (MM/YYYY)___________________________
4. What is your ultimate degree objective here at UCLA:
MS
PhD
5. When do you realistically expect to achieve your degree objective: quarter/year_________________
6. What is your source of support during each of the quarters? Choose as many as apply:
Fall
Winter
Spring
Teaching Assistantship
Graduate Student Researcher
Department Fellowship
External Fellowship
Other (specify):
None
7. Do you have outside employment?
No
Part-time
Full-time
8. Do you currently have a desk in a lab (or elsewhere) outside the EE Dept. cubicle areas?
No
Yes
9. Please give your preferred cubicle area:
No preference
5th Floor
6th Floor
10. Do you have any special situation that applies to this request?
None
I already have a cubicle but I need to request a switch
I want to be assigned a specific cubicle, replacing a student in my group who is leaving
Other special situation (please give details)
_________________________________________________________________
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