| If Permanent Resident/Other | Country of Citizenship __________________ |
| Reference letters requested from: | |
| Name | REU Program Office Use Below |
| _____________________________ | £ Received (Date ____________________) |
| _____________________________ | £ Received (Date ____________________) |
| _____________________________ | £ Received (Date ____________________) |
| Institutional Contact Information: |
| Academic Department | __________________________________________ |
| Institution | __________________________________________ |
| Institution Address | __________________________________________ |
| __________________________________________ |
| Telephone | ____________________________ |
| Fax | ____________________________ |
| E-mail | ____________________________ |
| Home Contact Information (during the academic year): |
| Home Address | __________________________________________ |
| __________________________________________ |
| Telephone | ____________________________ |
| Fax | ____________________________ |
| E-mail | ____________________________ |
| Permanent Home Contact Information: £ Same as above |
| Home Address | __________________________________________ |
| __________________________________________ |
| Telephone | ____________________________ |
| Fax | ____________________________ |
| E-mail | ____________________________ |
| Academic Information: |
| Academic Major | __________________________________________ |
| Degree Objective | £ B.A. £ B.S. £ Other __________ |
| Expected Graduation Date | ____________________________ (as MM/YYYY) |
| Name of: £ Department Chair | __________________________________________ |
| or £ Major Advisor | __________________________________________ |
| Transcripts | Please attach one copy of undergraduate academic
transcripts to the back of this application. Transfer
students should include transcripts from all
undergraduate institutions attended. |
| Grade Point Average (GPA) | Overall GPA ________ Major GPA ________ |
| Reference letters requested from:
|
| Name Affiliation (Department and Institution)
|
| _____________________________ | ____________________________________ |
| ____________________________________ |
| _____________________________ | ____________________________________ |
| ____________________________________ |
| _____________________________ | ____________________________________ |
| ____________________________________ |
Provide a concise description of your research interests relative to the projects that are available under the U.S.-[FOREIGN SITE] REU Program. State how participation in the REU program will benefit your academic training and how it will further your intended professional career. (Limit your narrative answer to one page.)