RECEIVED

1976 GRADUATE SUMMER SESSION IN EPIDEMIOLOGY

APR 1 1976

APPLICATION FOR ADMISSION

School of Public Health
Epidemiology

June 20-July 10, 1976

NOTE: PRINT USING INK

1. Name Claire Cecile Bourguet
First Middle Last

2. Exact Title Trainee 3. Department Epidemiology

4. Employer (Student) 5. Office Phone 919 966-2241

6. Office Address Dept of Epid, UNC School of Public Health, Chapel Hill N.C. 27514
No. Street City State Zip

7. Home Address 5A Kingswood Apts. Chapel Hill N.C. 27514
No. Street City State Zip

8. Home Phone 919 929-6488 9. Sex F 10. Date of Birth 1/9/48

11. Teaching Activities

School or Agency	Subject	Types of Students	Hours Per Year

12. College, University, and Professional Education

School	Major	Degree	Year
Cornell Univ.	Psychology	B.A.	1971
Bryn Mawr College	Social Psych	M.A.	1973
Univ. of North Carolina	Epidemiology

13. Professional Experience (Start with Present Position)

Employer	Position	Duty	No. of Years
Harvard School Public Health	Research Assist.		2

14. Have you had any graduate level courses in statistics? Yes No

Course Title	Hours	School	Year Taken
Stats. for Beh. Sciences	5	Bryn Mawr College	1972
Anova & Mult. Regression	3	U. of North Carolina	1975

15. Have you had any graduate level courses in epidemiology? Yes No

Course Title	Hours	School	Year Taken
Intro to Epid	3	U. of North Carolina	1975
Epidemiological Investigation	3	"	1976
Appl. of Psych Theory & Research to Health	3	"	1976
	OVER

Source: https://www.industrydocuments.usf.edu/docs/hnmp0227