The University of North Carolina at Chapel Hill
 

Personal Information

First Name*: MI: Last Name*:

Date of Birth (mm/dd/yy)*: / /

Gender*: Male Female

Are you currently a citizen or permanent resident of the United States?*
Yes
No

Contact Information

Current
Address (1st line)*:
Address (2nd line):
City/State/Zip Code*: / /
Daytime Telephone*: - -
Evening Telephone: - -
Email Address*:


Permanent
Address (1st line):
Address (2nd line):
City/State/Zip Code: / /
Telephone: - -

Undergraduate Information

College or University*:
Major Area(s) of Study*:
Date you plan to graduate (mm/yy)*:

/

Current Cumulative Grade-Point Average (GPA)*:


Fellowships, scholarships, awards or other academic honors

Relevant work, teaching and laboratory skills

If applicable, describe other research activities (academic year or summer) in which you have participated and/or courses you are currently enrolled in that are relevant to this application (prior experience is neither a requirement nor a disqualification for admission to the REU program)

References

Please provide us information for two faculty members able to comment on your potential for laboratory work.

Reference #1*

Name:
Title/Position:
Organization:
Email Address:
Telephone: - -

Reference #2*

Name:
Title/Position:
Organization:
Email Address:
Telephone: - -


Essay/Questions

Write an essay why you want to participate in the REU program.
Include a discussion of how this experience will help you achieve your career goals. (The textbox below will accommodate essays of any length)*

How did you learn about the REU program at UNC?*

What other summer programs have you applied to for 2010? (optional)

Please indicate your ethnic background. The University of North Carolina is committed to equal opportunity and does not discriminate on the basis of race, sex, color, national origin or handicap. (optional)

Caucasian
Hispanic
African American
Asian
Native American
Other

Did either of your parents graduate from a 4-year college or university? (optional)

Yes
No

Your typed name is a substitute for your signature. By typing your name, you certify that the information you provide is true and accurate to the best of your knowledge.*

Signature (Type your full name):

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