Application Form: Due March 12, 2018

Environmental Science Research Experience for Undergraduates

at Northern ArizonaUniversity

Name:______

Cell phone:______

I. Academic Year Contact Information

a) Address:______

______

b) Phone:______c) Email:______

II. Summer Contact Information (if different than above)

a) Address (summer):______

______

b) Phone:______c) Email:______

III. Contact information for 5-year Tracking (most students use their grandparent’s or parent’s address)

a) Contact Names: ______

b) Address: ______

______

c) Phone: ______d) Email ______

IV. Educational Information

a) Last date of college/university enrollment (month/year OR current):______

b) Last/current college/university attended:______

c) Highest enrollment status attained (freshman, sophomore, …):______

d) Overall GPA:______

e) Last/current degree program (major/emphasis area):______

f) Anticipated degree completion date (month/year):______

g) List all colleges/universities attended and dates of attendance

1.

2.

3.

4.

h) Indicate the number of college/university courses in each of the following areas, in which you have received a grade of C or better:

Chemistry:_____

Physics:_____

Biology:_____

Environmental science:_____

Geology:_____

Engineering:_____

Math:_____

Other sciences:_____ please indicate course topics ______

V. Interests and Goals

a) Of the subject areas listed above (III h), indicate the three areas of greatest interest to you in order of preference (1 = most interesting . . . )

1.

2.

3.

b) What is the highest degree you expect to achieve? □ Associates□ Bachelors

□ Masters□ Ph.D.

□ M.D. or other professional degree

VI. Personal Information

a) We are only able to accept U.S. Citizens or Permanent Residents, please confirm your status.

Yes, I am a U.S. Citizen or Permanent Resident □

b) Check one (optional):

□ Native American□ African American□ Caucasian

□ Hispanic□ Asian□ Other (please specify)

______

c) Check one (optional):

□ Female□ Male

NorthernArizonaUniversity is an Equal Opportunity/Affirmative Action Employer. Applications from minorities and women are especially encouraged.

VII. Letters of Reference

List the names, addresses, phone numbers, and email of two people who are providing confidential letters of recommendation on your behalf. At least oneletter must be from a college/university faculty member who is familiar with your science background. These references mayalso be contacted if you are in the final pool of applicants.

REFERENCE 1

NAME:______

ADDRESS______

ADDRESS______

PHONE______

E-MAIL______

REFERENCE 2

NAME:______

ADDRESS______

ADDRESS______

PHONE______

E-MAIL______

VIII. Essay

Please submit a 1-2 page essay (typed, double spaced, 12 point font) indicating

a) why you are interested in Environmental Science research

b) which of the REU Projects interest you the most in and why (see for mentor/project list)

c) what you hope to do for a career

A complete REU application includes:

  1. Application form.
  2. Copy (unofficial OK) of all college/university transcripts (including current courses)
  3. Two letters of recommendation
  4. Essay

All application items should be sent to:

Deadline for applications is March 12, 2018

For additional program information or if you have any questions, please check out our website at contact the program directors:
Ted

Dr. Liza

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