1 Prairie View Solar Observatory REU Application Name (First, Last): Personal Information: Street: City: State: Phone: Cell: Email: URL: Home/Permanent Address (if different from above): Street: City: State: Phone: Cell: Email: URL: US Citizen/Permanent Resident? Yes / No Zip: Fax: Zip: Fax: Academic Information: College/University you presently attend: Location: City: State: Zip: Major/Minor: Cumulative Grade Point Average (GPA): Technical classes taken (Science, Math, Engineering, Computer): Number of years in degree program: Your current year in program: Estimated Graduation date: Honors and Awards (opt): Work experience (Please list your research or related work experience; include an additional page if necessary) Dates: Site: Phone: Responsibilities: Software/Hardware Experience: Dates: Responsibilities: Site: Phone: Software/Hardware Experience: Applications are due by April 1 (summer program) and July 15 (academic-year program) 2 Name (First, Last): Contacts for Letters of Recommendations/References (Please have two letters sent directly to Prairie View Solar Observatory BEFORE the deadline either by e-mail: sorin_pojoga@pvamu.edu or by mail: REU Program, Prairie View Solar Observatory, Prairie View A&M University, PO Box 307, Prairie View, TX 77446). Name: Dept Address Address (cont) City: Phone: Relationship: Name: Dept Address Address (cont) City: Phone: Relationship: Title: State: Fax: Zip: Email: Title: State: Fax: Zip: Email: Research Preferences (optional) You may write a few short sentences giving your area of interest (e.g. solar physics, astronomy, space science, engineering) and include if there is a specific person/project you wish to work on: Please list any other information that you think we may need to know: How did you first learn about the Prairie View REU program? ___ Faculty/Advisor ___ REU Poster/Flyer ___ Prairie View A&M Web Site ___ Friend ___ NSF Web site ___ AAS Web site/Meeting ___ Other (please specify): Applications are due by April 1 (summer program) and July 15 (academic-year program) 3 Name (First, Last): Personal Confidential Information This section is collected for the National Science Foundation who will use this information for statistical analysis only. Whether or not you decide to provide the following information will have no impact whatsoever on your application I chose to provide some or all of the following: ___ Yes ___ No Gender: ___ Male ___ Female Ethnic/racial status (please choose the one that most closely reflects the person’s recognition in the community). ___ American Indian or Alaskan Native ___ Asian ___ Black ___ Hispanic ___ Pacific Islander ___ White Are you a veteran of the U.S. Military? ___ Yes ___ No Do you have a disability that limits a major life activity? ___ Yes If yes please explain: ___ No Return all application BEFORE the deadline either by e-mail: eromashets@pvamu.edu or by mail: REU Program Prairie View A&M University P.O. Box 519, MS 2250 Prairie View, TX 77446 Applications are due by April 1 (summer program) and July 15 (academic-year program)