Nomination Form for 2016 ESP

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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.
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b. Is intellectually curious and innovative, i.e. poses questions.
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c. Is able to work well in groups.
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d. Is an independent thinker and is able to work
independently.
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e. Is self-motivated to complete tasks and assignments.
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f.
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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.
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