Application Form: Due March 11, 2016
Environmental Science Research Experience for Undergraduates
at Northern Arizona University
May 24 – July 29, 2016
Name:________________________________________________________________________
Cell phone:__________________________________
I. Academic Year Contact Information
a) Address:____________________________________________________________________
____________________________________________________________________________
b) Phone:_____________________ c) Email:________________________________________
II. Summer Contact Information (if different than above)
a) Address (summer):____________________________________________________________
____________________________________________________________________________
b) Phone:_____________________ c) Email:________________________________________
III. Contact information for 5-year Tracking (most students use their grandparent’s or parent’s
address)
a) Contact Names: _____________________________________________________________
b) Address: ___________________________________________________________________
_____________________________________________________________________________
c) Phone: ________________________________ d) Email __________________________
IV. Educational Information
a) Last date of college/university enrollment (month/year OR current):_____________________
b) Last/current college/university attended:___________________________________________
c) Highest enrollment status attained (freshman, sophomore, …):_________________________
d) Overall GPA:_______________
e) Last/current degree program (major/emphasis area):__________________________________
f) Anticipated degree completion date (month/year):___________________________________
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g) List all colleges/universities attended and dates of attendance
1.
2.
3.
4.
h) Indicate the number of college/university courses in each of the following areas, in which you
have received a grade of C or better:
Chemistry:_____
Physics:_____
Biology:_____
Environmental science:_____
Geology:_____
Engineering:_____
Math:_____
Other sciences:_____ please indicate course topics _________________________________
V. Interests and Goals
a) Of the subject areas listed above (III h), indicate the three areas of greatest interest to you in order
of preference (1 = most interesting . . . )
1.
2.
3.
b) What is the highest degree you expect to achieve? □ Associates
□ Bachelors
□ Ph.D.
□ Masters
□ M.D. or other professional degree
VI. Personal Information
a) We are only able to accept U.S. Citizens or Permanent Residents, please confirm your status.
Yes, I am a U.S. Citizen or Permanent Resident
□
b) Check one (optional):
□ Native American
□ Hispanic
□ African American
□ Asian
□ Caucasian
□ Other (please specify)
___________________________
c) Check one (optional):
□ Female
□ Male
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Northern Arizona University is an Equal Opportunity/Affirmative Action Employer. Applications
from minorities and women are especially encouraged.
VII. Letters of Reference
List the names, addresses, phone numbers, and email of three people who are providing
confidential letters of recommendation on your behalf. At least one letter must be from a
college/university faculty member who is familiar with your science background. These references
may also be contacted if you are in the final pool of applicants.
REFERENCE 1
NAME:
________________________________________________
ADDRESS
________________________________________________
ADDRESS
________________________________________________
PHONE
________________________________________________
E-MAIL
________________________________________________
REFERENCE 2
NAME:
________________________________________________
ADDRESS
________________________________________________
ADDRESS
________________________________________________
PHONE
________________________________________________
E-MAIL
________________________________________________
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VIII. Essay
Please submit a 1-2 page essay (typed, double spaced, 12 point font) indicating
a) why you are interested in Environmental Science research
b) which of the REU Projects interest you the most in and why (see www.mpcer.nau.edu/reu
for mentor/project list)
c) what you hope to do for a career
A complete REU application includes:
1. Application form.
2. Copy (unofficial OK) of all college/university transcripts (including current courses)
3. Two letters of recommendation
4. Essay
All application items should be sent to:
Theodore.Martinez@nau.edu
Deadline for applications is March 11, 2016
For additional program information or if you have any questions, please check out our website at
http://nau.edu/Merriam-Powell/Research-Experience/ or contact the program directors:
Ted Martinez Theodore.Martinez@nau.edu
Dr. Amy Whipple Amy.Whipple@nau.edu
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