Collaborative Research in the Chemical Sciences
Research Experiences for Undergraduates
A Ten Week Summer Program
 

Program Application

The application deadline is February 15, 2008
* indicates required fields
Personal Information
Name*

Telephone Number*

 Email Address*
Address*:
Line 1
Line 2
City
State Zip 		Permanent Address: (if different)
Line 1
Line 2
City
State Zip
Citizenship*: (Only US citizens & permanent residents are eligible)

Academic Information
Current School*
 Major Area of Study*
Year in School*
 Overall GPA*
 GPA in Major*

Research Interests
List the 3 faculty members whose research programs most interest you. Provide a brief summary of why you would like to work with these faculty.
See a list of research programs (clicking this link will open a separate window)

Research Program 1st Choice (Faculty Name) *

 Explanation

Research Program 1st Choice (Faculty Name) *

 Explanation

Research Program 1st Choice (Faculty Name) *

 Explanation

Experience & Skills
What computer applications are you able to use?
List any other relevant equipment or technologies with which you are familiar.
Briefly list your laboratory experience, if any.
List any research or other experience you may have that makes you a good candidate for this internship.
How did you hear about this research opportunity? 

Letters of Reference
Please give the following information for the faculty members who will be completing your reference forms.
First Reference:
Name*

Telephone Number*

 Email Address*
Please indicate a brief rationale for choosing this faculty member.*
Second Reference:
Name*

Telephone Number*

 Email Address*
Please indicate a brief rationale for choosing this faculty member.*

Personal Statement*
Prepare a personal statement outlining your interest in this program and your relevant background and skills. In particular please address:
• Why you want to participate in the program.
• What you hope to learn, or how you hope to benefit from the program.
• What skills you have that would be useful in a research environment. (This may include academic or technical skills, or general work habits. Previous research experience is not a prerequisite for this program.)

You may copy and paste text into the area below. Please limit your statement to the equivalent of two double spaced pages.

Demographic Information

This information will be separated from the rest of your application before it is sent out for review. The purpose of this section is to collect demographic information for the granting agency (the National Science Foundation). Completion is voluntary. Failure to complete this section of the application will not adversely affect your application to this program.
Gender
Female
Male
Decline to State 		Birthdate
Ethnicity/Race (Check all that apply)
Not Known
American Indian/Alaskan Native
Asian
Black or African American
Hispanic
Native Hawaiian/Pacific Islander		 White
    Hispanic or Latino
    Not Hispanic or Latino
Other (Please Specify)
Decline to State

Disclosure Agreement*
Do you give us permission to share your application, including your transcripts and letter of recommendation, with faculty members affiliated with this program?
I Agree

 
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This material is based upon work supported by the REU Site Program of the National Science Foundation No. CHE-0453466. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.
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