North Carolina A&T State University
School of Agriculture & Environmental Sciences
Undergraduate Research Scholars Program (URSP)
(Complete form online, print and submit with original signatures)
Applicant’s Name: ___________________________
Major: ___________________ Classification:  Junior
Banner Student ID No.: ___________________
Senior Cumulative GPA: ____
Local Address: ________________________________________________________________________
Telephone (No(s): _____________________________________________________________________
Preferred Mailing Address: ______________________________________________________________
Email Address: ________________________________________________________________________
Are you a member of a professional organization in your field? Yes 
No 
If yes, list the organizations(s)
1. ______________________________________________________________
2. ______________________________________________________________
3. ______________________________________________________________
NARRATIVE: Please answer the following questions on a separate sheets (not to exceed 3 pages).
Responses must be typed and double-spaced.
1. Give a brief description of your career interest and state your long-term (3-5 years) goals.
2. Explain how participation in this program will assist you in achieving your career goals.
3. Briefly discuss what current issue(s) in your area of study you are most interested in researching,
and elaborate why.
4. Have two (2) recommendations (form attached) completed by faculty and or an advisor and a
copy of your official transcript sent by recommender to the URSP Committee at the address
below. These letters should speak to ones observation of your abilities and skills and readiness
for this program.
Signatures (complete the document on line, print and get original signatures.)
______________________________________
Faculty Advisor
________________________________
URSP Faculty Mentor
Completed application should be sent by April 15, 2016 to the following address:
Dr. Valerie L. Giddings
North Carolina A&T State University
Undergraduate Research Scholars Program
1601 E. Market Street, C. H. Moore Agricultural Research Station, Greensboro, NC 27411
Tel. (336) 285-4701 Fax (336) 334-7612
North Carolina A&T State University
School of Agriculture & Environmental Sciences
Undergraduate Research Scholars Program (URSP)
Recommendation Form
Please evaluate the undergraduate research applicant on the following qualities by placing an “x” in the
appropriate space in the chart. If you are unable to, or have no basis for evaluating the applicant, please check
“Not Observed.” Print form and complete.
Application’s Name _____________________________
Qualities
Communication Skills
Critical Thinking Skills
Initiative
Motivation
Dependability/Maturity
Departmental Service
University Service
Community Service
Outstanding
Good
Applicant’s Signature _____________________
Satisfactory
Fair
Poor
Not Observed
In the space below, or on a separate sheet, provide additional comments regarding this applicant’s skills,
including written, oral, social, and research potential: _____________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Recommender’s Name & Title: __________________________________________________________________
Relationship to Applicant:  Advisor
 Instructor
 Other ___________________________
(Specify title/position)
Length of time applicant known to you and in what capacity did you observe the qualities rated above:
____________________________________________________________________________________________
Do you  Highly Recommend
 Recommend
 Not Recommend
Please return this form by April 15, 2016 to the following address:
Dr. Valerie L. Giddings
North Carolina A&T State University
Undergraduate Research Scholars Program
1601 E. Market Street, C. H. Moore Agricultural Research Station
Greensboro, NC 27411
Tel. (336) 285-4701 Fax (336) 334-7612