| |
| Please fill in all fields in this form. For fields that do not apply to you, enter "NA". |
| Personal Background |
| Title: |
|
| First Name: |
|
| Last Name: |
|
| Nickname or preferred name: |
|
| Email Address: |
|
| Birthdate: |
|
| United States Citizen: |
Yes
No
|
| Gender: |
|
| Ethnicity, (check all that apply): |
African American, not of Hispanic Origin
American Indian or Alaskan Native
Asian or Pacific Islander
Caucasian/White, not of Hispanic Origin
Hispanic
Other
I do not wish to provide this information
|
| If Other Ethnicity, please specify: |
|
| Current Address |
| Street Address: |
|
| Street Address (2): |
|
| City: |
|
| State or Province: |
|
| Zip Code: |
|
| Phone Number: |
|
| Last date you can be contacted at your current phone number: |
|
| Permanent Address |
| Click here if your permanent address is the same as your current address: |
|
| Street Address: |
|
| Street Address (2): |
|
| City: |
|
| State or Province: |
|
| Zip Code: |
|
| Phone Number: |
|
| Education |
| Undergraduate College or University: |
|
| City of College or University: |
|
| State or Province of College or University: |
|
| Major: |
|
| Currently enrolled as: |
|
| Date Spring term ends: |
|
| Date Fall term begins: |
|
| Anticipate taking: |
|
| When? |
|
| Expected Graduation Date: |
|
| Do you plan to enroll in: |
|
| When? |
|
| In what field (if you have a strong idea)? |
|
| What are your plans after graduation (if not graduate school)? |
|
| Have you participated in undergraduate research previously? |
|
| If yes, when and where? |
|
| College Science Courses Already Taken (with grades as they appear on your transcript): |
|
| Cumulative GPA: |
|
| Science GPA: |
|
| Science Credits Taken: |
|
| Please List: Courses Taking Spring 2009: |
|
| References |
| Provide the names of two professors who know you well and will submit letters of recommendation. |
| Please double check the e-mail addresses and make sure you type them in carefully.
If there is an error in the e-mail address, the professor will not receive our request for the letter of recommendation. |
| When you click the submit button, the professor will be emailed a request for a letter of recommendation. |
 | | First Reference |
| Title: |
|
| First Name: |
|
| Last Name: |
|
| Email: |
|
| | Second Reference |
| Title: |
|
| First Name: |
|
| Last Name: |
|
| Email: |
|
| Desired Research Advisors |
| List the three professors in our program whose research most interests
you and whose group you would like to join for the summer.
View the list of Mentors (opens a new window) |
| Choice One: |
|
| Choice Two: |
|
| Choice Three: |
|
| | Explain why you have chosen these mentors. What about their research methods interests you? | | |
|
| | What do you hope to gain from a summer research experience in our REU program?
How might the Summer research experience help you to attain your career goals? | | |
|
| |
Please submit an application only once. If you have a major change to something after you submit, please contact us at
ungerman@lamar.colostate.edu.
|
Please note that information you provide in this application may be used for statistical analysis that my help ensure the continued growth and vitality of summer research programs for undergraduate students. All information provide will remain confidential. If you wish to withhold the information on this application form from the statistical analysis, please indicate below.
|
|
|
|
