SIUC REU Application

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Interdisciplinary Materials Research
Research Experience for Undergraduates

Program Projects Application Contact

In addition to submitting this form, please mail a copy of transcripts from all colleges and universities attended to:

REU Site Coordinator

Department of Chemistry and Biochemistry

Neckers, Rm 222, MC 4409

1245 Lincoln Drive

Southern Illinois University

Carbondale, IL 62901

Alternatively, a downloadable version of the form is provided. You can fill this form and send it with your relevant transcripts. Please choose either this on-line form or downloadable PDF form but do not submit both.

For the online form:

Attention: If you are submitting your application with this on-line form, the only material you should mail is a copy of all relevant college transcripts. All fields marked with an * are required. Please use a web browser with JavaScript enabled to submit this form.

Summer 2008 Application Form
Applications due by March 3, 2008

	Title:
*	First Name:
*	Last Name:
	Middle Initial:
*	E-mail Address:
*	Mailing Address:
	Mailing Address 2:
*	City:
*	State:
*	Zip Code:
*	Telephone:
*	Permanent Home Address:
	Permanent Home Address 2:
*	City:
*	State:
*	Zip:
*	Telephone:
	Academics Please list all colleges and universities attended, starting with the most recent. (Note: you will need to provide unofficial transcripts from each of these institutions in your application packet.)
*	Current College or University:
*	City:
*	State:
*	Major:
*	Dates of Attendance:
*	Expected Graduation Date:
*	Current GPA:

	Other Colleges Attended:
	Summer Research
*	Summer Dates of Availability:
*	Review the list of potential research topics and suggest topics of particular interest to you. Identify four faculty advisors from those listed that you would prefer to work with.
	Personal Statement Provide a 1-page personal statement listing any honors, prizes or publications, and describing your previous research experience (if any), your plans after graduation and any additional information about yourself that you feel would be useful in evaluating your application.
	References Please provide the names, phone numbers and E-mail address of one, or preferably two, of your professors. An e-mail will be sent to the addresses provided requesting a letter of recommendation. Please list someone you are certain will provide a letter of recommendation.
*	Faculty Title:
*	Faculty Name:
*	Faculty Telephone:
*	Faculty E-mail Address:

	Faculty Title:
	Faculty Name:
	Faculty Telephone:
	Faculty E-mail Address:

	Personal Information Submitting the following information is optional, but provides important information that will be used for reporting statistics to the National Science Foundation. This section of the application form is based on NSF Form 1225.
	Citizenship status	US Citizen Permanent Resident Other immigration status
	Gender:	Female Male
	Which one of these categories best describes your ethnic/racial status?	American Indian or Alaskan Native Asian Black, not of Hispanic Origin Hispanic Pacific Islander White, not of Hispanic Origin Other, not listed
	Do you have a disability which limits a major life activity?	Yes No If yes, please explain briefly:
	Are you a veteran of the U.S. military?	Yes No

You may when done, or if you want to start over.