Application for Summer Undergraduate Research Program nsf research Experiences for Undergraduates (reu) – 2016 Please Print Clearly or Type

Name: ___________________________________________________________________________________

Last First Middle

Current Street Address: ______________________________________________________________________

City: ___________________________________ State: ____________ Zip Code: _______________________

Phone: ________________________________ Email: _____________________________________________

 U.S. Citizen  Permanent Resident

Ethnicity/Race:  Hispanic or Latino  Not Hispanic or Latino

Race (Select one or more):  American Indian or Alaska Native  Asian  Black or African American

 Native Hawaiian or Other Pacific Islander  White

Gender:  Male Female Other Prefer not to disclose

*I hereby grant the NSF-REU program permission to use the above information for statistical analysis purposes only, with the provision that no personal information will be released to anyone besides those few, qualified researchers doing the statistical analysis and that these researchers will only report/publish aggregate statistics. Your willingness to participate in this statistical survey may help ensure the continued growth and vitality of this federally sponsored program.

College or University: _______________________________ Major: __________________________________

Current year in school: ________________________________ Present GPA: ___________________________

Expected Graduation Date: ________________ Academic Honors or Awards: ___________________________

First choice: _______________________________________________________________________________

Second choice: _____________________________________________________________________________

Third choice: ______________________________________________________________________________

1. 
   Name:__________________________________ (2) Name: ________________________________________
   

Email: ______________________________________ Email: _________________________________________

I certify that all information (including transcripts) is valid and true to the best of my knowledge

Signature: _____________________________________________ Date: ________________________________

Send application materials to: Dr. Yun Ji NSF IREC REU Program UND und.chem_REU_IREC@und.edu

Applications due by March 31, 2015. Late applications will be considered if we have space remaining in the program. http://arts-sciences.und.edu/chemistry/und_reu_irec/