Certificate in Engineering for Energy Sustainability Declaration Form

Certificate in Engineering for Energy Sustainability

College of Engineering

University of Wisconsin-Madison

Declaration Form

Thank you for your interest in the Certificate in Engineering for Energy Sustainability. This online application form is required to declare the certificate.

Please provide your information below and affirm your eligibility. On the next page, you will be asked to fill out a tentative study plan for completing the certificate requirements.

Before you complete this application, you should either schedule an advising appointment in Starfish with the certificate coordinator, Scott Williams (spwilliams@wisc.edu) or complete this online orientation video explaining the certificate and its requirements.

Contact Information

First Name

Last Name

Student ID # (10-digit)

Email address

Current Major(s)

Major Advisor(s)

Graduation Year (anticipated)

Graduation Year (anticipated)
	Year	Semester



Year/Semester	Year - Year/Semester	Semester - Year/Semester

To be eligible to declare, you must meet the following requirements (which will be verified):

Be a current undergraduate student at UW-Madison
Are not earning the Certificate in Sustainability
Have met with an advisor or have completed the online video orientation.
For Engineering students only: Have met progression requirements

Yes, I meet these requirements
No, I do not meet these requirements