Excel! Research Scholars Program


OfficeUseOnly

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DateReceived

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Applicantmustcompleteall pagesofthisapplication.

PERSONALINFORMATION

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Student ID: SocialSecurityNumber: ApplicationDate:

Full Legal Name: First: Middle: Last:

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Permanent address:

City/State/Zip:

Country:

Current address:

City/State/Zip:

Country:

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Local or campus phone: Cellular phone: Email address:

Gender: / Male / Female / Date of Birth:
(Month/Day/Year) / Marital status:

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Racial EthnicBackground: Please feel free to check all that apply:

Black, Non-Hispanic / Hispanic / Native Hawaiian/Pacific Islander / American Indian or Alaskan Native
White, Non-Hispanic / Asian / Other:

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Country of Citizenship:Country of Birth:

EDUCATIONALINFORMATION

Collegeoruniversitywhereyouarecurrentlyenrolled:

Currentmajor(s): Degree(i.e.,B.A.,B.S.):

Expecteddateofgraduation: Expectedfieldofgraduatestudy:

CurrentcumulativeGPA: CurrentGPAinmajor:

Totalcreditscompleted: Total numbers of credits in progress:

Classification:Freshman Sophomore Junior Senior 5th Year Senior

List any academic enrichment programs you participate in or are applying to (e.g. Minnesota Future Doctors, Young Scholars, Aquinas Scholars, Mellon Mays, etc.):

Indicate your major field of study:

Arts and Social Sciences

Applied Sciences

Which of the following best describes your commitment to attend graduate school?

FINANCIAL INFORMATION
Are you currently eligible to receive financial aid? / Yes / No
With regard to the university financial aid office, what is your current status? / Dependent / Independent

*Note: you are independent if you filed your own tax return in the most recent year and were not claimed as a dependent on anyone else’s taxes.

FAMILY BACKGROUND
With whom do you maintain permanent residence? / Mother / Father / Both Parents / Legal Guardian / Self-Supporting
Were you claimed as a dependent on your parent(s) or legal guardian’s tax return? / Yes / No
Did your mother graduate from a four-year college? / Yes / No / Community College? / Yes / No
Did your father graduate from a four-year college? / Yes / No / Community College? / Yes / Yes
STATEMENT OF PURPOSE

Statement of Purpose: This section of the application helps us get to know you better. It also helps us become familiar with your writing strengths and areas of challenge. On a separate sheet of paper, please submit astatement of purpose which should be no more than 1,000 words, 1.5 spaced pages with 1 inch margins on both sides. In this essay you should discuss the following:

  • Why did you decide to pursue the Excel! Research Scholars Program?
  • What are your current research interests? The clearer you state your research interests (whether they are specific or general), the easier it will be to identify potential faculty mentors.
  • Describe how previous research projects, coursework or other experiences have influenced your interests.
  • What are your future educational and career goals, and how does the Excel! Research Scholars Program fit with your goals?

Your Statement of Purpose should also respond to this important question:

  • From what you know about the Excel! Research Scholars Program, once you have completed the training and have returned from the Journey for Justice: A Study of the American Civil Rights Movement Study Tour of the South how do you plan to use what you have learned to help others?

ADDITIONAL INFORMATION

Please list any summer 2016academic year internships, classes, work, or activities that might hinder you from fulfilling your obligations to the Excel! Research Scholars Program:

Will you be available for an 8 week, 40 hour per week paid Summer Research Institute in summer 2016? / Yes / No
Letters of Recommendation and Deadline:
All prospective applicants are required to secure two (2) letters of recommendations. We encourage you to secure at least one (1) faculty recommendation from someone within your field of study. Confidential Recommendation Forms can be found on the Excel! Program website. Send the followinge-mail link to recommenders: If the link does not work, copy and paste the URL into your browser. Request that theyfill out the Confidential Recommendation Form and send them directly to the Excel! Research Scholars Program office no later than the application deadline. Recommendations received directly from prospective students will not be accepted. Applications will be considered on a case by case basis after the final deadline.
______
Signature / Date

By signing this application, you affirm that the information therein is true and correct toyour knowledge. You also agree to allow the Excel! Post-baccalaureate Achievement Programgather further information as needed from offices such as Financial Aid, Registrar, and Admissions. Should the information you provide here beinaccurate or false, you understand that your application will no longer be considered, and if already admitted to the program, you could be subject to dismissal. This information will be kept confidential. Return the completed application to University of St. Thomas, Excel! Post-baccalaureate Achievement Program, Aquinas Hall 319, 2115 Summit Avenue, St. Paul, MN 55105.

APPLICATION CHECKLIST

You are encouraged to review your application thoroughly before submitting it for consideration. Incomplete applications will not be considered. Below is a checklist for your convenience. You are responsible for making sure that your documents, including letters of recommendation from faculty, are received on time. Letters of recommendation are confidential and must come directly from your recommenders. Recommendations coming from students will not be accepted. Make sure to sign your application for full consideration.A complete application consists of the following components:

1. Completed Application Form (make sure you have answered all questions)

2.

Student Aid Report (SAR). If you do not receive financial aid you must secure a letter from the Office of Financial Aid confirming your financial status.

3.

Statement of Purpose

Resume

Transcript (unofficial is permissible)

Two (2) letters of recommendation (Note the application instructions on the website as to who are eligible to write letters of recommendation for you.)

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