Office Use Only
Excel! Research Scholars Program
Date Received
Mail: Aquinas Hall 319
2115 Summit Avenue
St. Paul, MN 55105
excelscholars@stthomas.edu
Excel! Research Scholars Program
2016 Application
Applicant must complete all pages of this application.
PERSONAL INFORMATION
Student ID:
Social Security Number:
Full Legal Name: First:
Application Date:
Middle:
Last:
Permanent address:
Current address:
City/State/Zip:
City/State/Zip:
Country:
Country:
Local or campus phone:
Gender:
Cellular phone:
Male
Female
Email address:
Date of Birth:
(Month/Day/Year)
Marital status:
Racial Ethnic Background: Please feel free to check all that apply:
Black, Non-Hispanic
Hispanic
Native Hawaiian/Pacific Islander
White, Non-Hispanic
Asian
Other:
Country of Citizenship:
American Indian or Alaskan Native
Country of Birth:
EDUCATIONAL INFORMATION
College or university where you are currently enrolled:
Current major(s):
Degree (i.e., B.A., B.S.):
Expected date of graduation:
Expected field of graduate study:
Current cumulative GPA:
Current GPA in major:
Total credits completed:
Total numbers of credits in progress:
Classification:
Freshman
Sophomore
Junior
Senior
5th Year Senior
List any academic enrichment programs you participate in or are applying to (e.g. Minnesota Future Doctors, Young Scholars, Aquinas Scholars,
Mellon Mays, etc.):
Indicate your major field of study:
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Arts and Social Sciences
Select
Applied Sciences
Select
Which of the following best describes your commitment to attend graduate school?
Select
FINANCIAL INFORMATION
*Information in this section is for confidential demographic data only. All applicants are required to submit a Student Aid Report (SAR).
Are you currently eligible to receive financial aid?
Yes
No
With regard to the university financial aid office, what is your current status?
Dependent
Independent
*Note: you are independent if you filed your own tax return in the most recent year and were not claimed as a dependent on anyone else’s taxes.
FAMILY BACKGROUND
With whom do you maintain permanent residence?
Mother
Father
Were you claimed as a dependent on your parent(s) or
legal guardian’s tax return?
Yes
No
Did your mother graduate from a four-year college?
Yes
No
Did your father graduate from a four-year college?
Yes
No
Both Parents
Legal Guardian
Self-Supporting
Community College?
Yes
No
Community College?
Yes
Yes
STATEMENT OF PURPOSE
Statement of Purpose: This section of the application helps us get to know you better. It also helps us become familiar with your writing strengths and areas
of challenge. On a separate sheet of paper, please submit a statement of purpose which should be no more than 1,000 words, 1.5 spaced pages with 1 inch
margins on both sides. In this essay you should discuss the following:


Why did you decide to pursue the Excel! Research Scholars Program?
What are your current research interests? The clearer you state your research interests (whether they are specific or general), the easier it will
be to identify potential faculty mentors.

Describe how previous research projects, coursework or other experiences have influenced your interests.

What are your future educational and career goals, and how does the Excel! Research Scholars Program fit with your goals?
Your Statement of Purpose should also respond to this important question:

From what you know about the Excel! Research Scholars Program, once you have completed the training and have returned from the Journey
for Justice: A Study of the American Civil Rights Movement Study Tour of the South how do you plan to use what you have learned to help
others?
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ADDITIONAL INFORMATION

Please list any summer 2016 academic year internships, classes, work, or activities that might hinder you from fulfilling your obligations to the Excel! Research
Scholars Program:
Will you be available for an 8 week, 40 hour per week paid Summer Research Institute in summer 2016?
Yes
No
Letters of Recommendation and Deadline:
All prospective applicants are required to secure two (2) letters of recommendations. We encourage you to secure at least one (1) faculty recommendation
from someone within your field of study. Confidential Recommendation Forms can be found on the Excel! Program website. Send the following e-mail link
to recommenders: http://www.stthomas.edu/gro/students/excelresearch/eligibilityandapplication/. If the link does not work, copy and paste the URL into
your browser. Request that they fill out the Confidential Recommendation Form and send them directly to the Excel! Research Scholars Program office no
later than the application deadline. Recommendations received directly from prospective students will not be accepted. Applications will be considered on a
case by case basis after the final deadline.
_____________________________________________________
Signature
Date
By signing this application, you affirm that the information therein is true and correct to your knowledge. You also agree to allow the Excel! Postbaccalaureate Achievement Program gather further information as needed from offices such as Financial Aid, Registrar, and Admissions. Should the
information you provide here be inaccurate or false, you understand that your application will no longer be considered, and if already admitted to the
program, you could be subject to dismissal. This information will be kept confidential. Return the completed application to University of St. Thomas,
Excel! Post-baccalaureate Achievement Program, Aquinas Hall 319, 2115 Summit Avenue, St. Paul, MN 55105.
APPLICATION CHECKLIST
You are encouraged to review your application thoroughly before submitting it for consideration. Incomplete applications will not be
considered. Below is a checklist for your convenience. You are responsible for making sure that your documents, including letters of
recommendation from faculty, are received on time. Letters of recommendation are confidential and must come directly from your
recommenders. Recommendations coming from students will not be accepted. Make sure to sign your application for full consideration. A
complete application consists of the following components:
1.
2.
Completed Application Form (make sure you have answered all questions)
Student Aid Report (SAR). If you do not receive financial aid you must secure a letter from the Office of Financial Aid confirming
your financial status.
3.
Statement of Purpose
Resume
Transcript (unofficial is permissible)
Two (2) letters of recommendation (Note the application instructions on the website as to who are eligible to write letters of
recommendation for you.)
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