Penn Undergraduate Environmental Health Scholars Program

STEER ProgramPhone: (215)-746-3030

Center for Excellence in Environmental ToxicologyEmail:

Perelman School of Medicine

1313 Biomedical Research Building II/III (BRB II/III)

Philadelphia, PA 19104

Student Application

All information on the application must be typed or printed neatly. Please email the applicationbyMarch 1.

  1. Personal Information

Name: Last______First ______MI _____

Home Address: ______

City: ______State: ______Zip Code: ______

Home: (_____) ______– ______Cell: (_____) ______– ______Email: ______

COLLEGE: ______GPA (4.00 scale) Overall______

Gender: _____ Ethnicity (Optional): ______

  1. Academic Preparation

Describe your work exposure to science, including subjects taken, workshops/special classes and volunteer/work experience.

III.Research Interests

Include an ESSAYDescribing your scientific/research interests. Please be Brief and Specific to Environmental Health

IV.Supplemental Information

a)A nonofficial copy of your transcript

b)A Resume including extra-curricular activities, honors, and/or previous job experiences.

c)Two recommendation letters

Agreement form

Note the STEER program requires a full-time commitment for the summer

By submitting this application, you agree to work full-time and complete the required Internship Activitiesduring the 10-week program period if you are admitted as a Penn Undergraduate Environmental health Scholar.

Student Signature ______Date ______

Letter of Recommendation Form 1

All information on the application must be typed or printed neatly. The application is dueMarch 1.

Please mail or email to the contact information above.

Student: Last______First ______MI _____

Name of Recommender: ______Phone: (_____) ______– ______

1)How long have you known this student and in what context?

2)How would you describe this student?

3)Please comment on the student’s personal qualities, particularly in regard to character, integrity, values, and peer relationships.

4)Indicate by a  your ratings of this student in terms of academic skills and potential, compared to other college-bound students.

No Basis / Characteristics / Below Average / Average / Good / Very
Good / Excellent / One of the Top Few
Creativity, originality
Motivation
Independence, initiative
Intellectual ability
Academic achievement
Written expression of ideas
Effective class discussion
Disciplined work ethic
Potential for growth
Character
SUMMARY EVALUATION:

Additional Comments (use additional sheet if necessary):

Letter of Recommendation Form 2

All information on the application must be typed or printed neatly. The application is dueMarch 1. Please mail or email to the contact information above.

Student: Last______First ______MI _____

Name of Recommender: ______Phone: (_____) ______– ______

How long have you known this student and in what context?

How would you describe this student?

Please comment on the student’s personal qualities, particularly in regard to character, integrity, values, and peer relationships.

Indicate by a  your ratings of this student in terms of academic skills and potential, compared to other college-bound students.

No Basis / Characteristics / Below Average / Average / Good / Very
Good / Excellent / One of the Top Few
Creativity, originality
Motivation
Independence, initiative
Intellectual ability
Academic achievement
Written expression of ideas
Effective class discussion
Disciplined work ethic
Potential for growth
Character
SUMMARY EVALUATION:

5)Additional Comments (use additional sheet if necessary):

Revised 1/18STEER Application, Page 1 of 4