Online Application

Name (Last, First, MI) (Required)

Permanent Street Address (Required)

Permanent City ST ZIP Code

Permanent Phone (Required)

Present Street Address (Required)

Present City ST ZIP Code (Required)

Present Phone (Required)

Your E-Mail Address (Required)

Birth Date (mm/dd/yy) (Required)

College or University currently attending (Name, City, State) (Required)

Date degree expected (mm/yy) (Required)

Overall GPA (Required)

Math and Science GPA (Required)

Area of Scientific Interest (Required)

First faculty mentor you are interested in working with (Required)

Second faculty mentor you are interested in working with (Required)

Third faculty mentor you are interested in working with (Required)

Academic Level (at beginning of Spring 2012) (Required)

Enter Freshman through Senior or Other. If Senior or Other, indicate the number of remaining semesters after Summer 2012. If Other, please describe.

Academic major / Primary Area of Interest (Required)

(select no more than two)

Biochemistry

Biotechnology

Cell Biology

Ecology and Evolution

Environmental Biology

Genetics

Immunology and Infectious Disease

Microbiology

Molecular Biology

Physiology

Pre-medical, Pre-health, or Pre-professional

Gender (Required)

Male
Female

Are you either a US Citizen or Permanent Resident? (Required)

Yes
No

Ethnic / Racial Status: (Required)

select one

References

Please provide information on persons providing your two letters of recommendation. Letters should be obtained from your college science instructors, advisors, and/or mentors. Ask that references refer to: 1) your aptitude and interest in a scientific career in research and 2) the extent to which comparable research opportunities exist at your home institution.

Statement of Interest (Required)

Explain, in 1-2 attached pages, why you are interested in participating in our REU Site. Be sure to mention your areas of scientific interest and aspects of your background that you believe will ensure your success as an REU student participant. Include your name in the title of your document. Example: JohnDoe_StatementOfInterest.doc

Resumé (Required)

Attach a current copy of your resumé. Include your name in the title of your document. Example: JohnDoe_resume.doc

Agreement and Signature (Required)

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as an REU student participant, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Please type name and date in the field below

ONLY COMPLETE APPLICATIONS PACKETS WILL BE CONSIDERED.

Packets must contain: 1) this completed application form 2) a brief (1-2 pages) narrative describing why you are interested in joining our REU Site, 3) college transcript(s), 4) two letters of reference in sealed envelopes signed by the recommenders, and 5) a resumé. All materials, including letters of recommendation, must reach UW Oshkosh by Wednesay, February 29, 2012.

Send completed applications packets to:
Dr. Lisa A. Dorn
Program Director, UW Oshkosh / NSF REU Site
University of Wisconsin Oshkosh
800 Algoma Blvd.
45 Halsey Science Center
Oshkosh, WI 54901

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