ESP University of Wyoming College of Engineering and Applied Science Dept. 3295, 1000 E. University Ave. Laramie, WY 82071 NOMINATION FORM (type or print) Student___________________________________________________________________________________________ Nominating Math/Science Teacher____________________________________________ Email___________________ School____________________________________________________________________ Phone (_____)___________ Address____________________________________________ City_______________ State________ Zip___________ Please complete the following: The student applicant: Seldom/Never Occasionally Often/Always a. Is respectful of teachers and other students. _______ _______ _______ b. Is intellectually curious and innovative, i.e. poses questions. _______ _______ _______ c. Is able to work well in groups. _______ _______ _______ d. Is an independent thinker and is able to work independently. _______ _______ _______ e. Is self-motivated to complete tasks and assignments. _______ _______ _______ f. _______ _______ _______ _______ _______ _______ Has good grasp of fundamental principles and can apply them to solve problems. g. Comprehends advanced ideas and concepts Attach a paragraph commenting on the applicant’s personality and maturity, including special qualities that would influence the applicant’s selection for the program SIGNATURE OF NOMINATING TEACHER/RESEARCH AGREEMENT SUBMIT FORM BY MARCH 31, 2016 TO THE RETURN ADDRESS ABOVE. I, _________________________________________________ ____________________________________________ Name (typed or printed) Title Agree to provide a forum in my class(es) for the participant to present his/her research during the academic year. Engineering Summer Program, Laramie, Wyo., June 19-25, 2016 For more information contact Jeff Anderson at 307-766-3180 or e-mail [email protected] ESP is sponsored by: Ellbogen Next Generation Engineering Program, College of Engineering and Applied Science, Halliburton Foundation, Kester Funding, UW Summer Session and Winter Courses, Union Wireless, UW Academic Affairs, Wyoming Engineering Society, CEAS Engineering Initiative and the Kennedy Endowment. Persons seeking admission, employment, or access to programs of the University of Wyoming shall be considered without regard to race, color, religion, sex, national origin, disability, age, veteran status, sexual orientation, or political belief.