Summer Internship NSF/LSAMP Application Eligibility LSAMP STEM (Science, Technology, Engineering, Mathematics) Scholars Goal The goal of the LSAMP STEM Scholars Summer Internship program is to assist underrepresented minority students** in achieving academic excellence through research experiences. Stipend LSAMP scholars who meet the minimum 2.8 GPA requirements and participation will receive a modest stipend at the end of the summer semester. Contacts Dr. PN Achar, Director for NSF/LSAMP Program Email: pachar@kennesaw.edu, Dept of Biology & Physics, Science Building, Room 334 Sigurdur Greipsson- Faculty Research Mentor Email: sgreipss@kennesaw.edu Application Due on January http://lsamp.kennesaw.edu/ SUMMER RESEARCH INTERNSHIP APPLICATION FORM LOUIS STOKES ALLIANCE FOR MINORITY PARTICIPATION – LSAMP IN THE SCIENCES Please print or type NAME_____________________________________________________________________________ ADDRESS__________________________________________________________________________ __________________________________________________________________________ TELEPHONE/Cell #___________________________________________________________________ Area code Number Email Address: _______________________________________________________________________ ETHNICITY: Hispanic or Latino Yes No RACE: African-American or Black Alaskan Native American Indian (Native American) Asian Native Hawaiian or other Pacific Islander White or Caucasian Other. Specify ________________________________________________________________ GENDER Female Male CITIZENSHIP: US. CITIZEN NATURALIZED CITIZEN FOREIGN OTHER COLLEGES ATTENDED (If applicable) ____________________________________________ COLLEGE OR UNIVERSITY CLASS LEVEL IN THE SUMMER 2012 Freshman Sophomore Junior Senior YOUR MAJOR AT KENNESAW STATE UNIVERSITY _________________________________ WHERE WOULD YOU LIKE TO CONDUCT YOUR RESEARCH/Internship? ____________________________ HAS THIS RESEARCH/INTERNSHIP BEEN APPROVED?____________________ HOW MUCH MONEY WILL YOU EARN (MAKE) WITHOUT MONEY FROM NSF/LSAMP?_________________ LIST THE SUBJECT(S) THAT YOU WOULD LIKE TO RESEARCH AT KENNESAW STATE UNIVERSITY OR OUTSIDE KSU WHAT ARE YOUR PLANS AFTER GRADUATING FROM KSU? BRIEFLY DESCRIBE YOUR CAREER GOALS. DESCRIBE YOUR SPECIFIC STRENGTHS AS A SCIENCE/MATH STUDENT. THE NEXT TWO QUESTIONS ARE OPTIONAL. HOWEVER, YOUR ANSWERS TO EITHER OR BOTH OF THESE QUESTIONS MIGHT HELP US TO QUALIFY YOU FOR THE KSU-LSAMP PROGRAM. Describe any cultural, social, or economic barriers you have faced in your pursuit of education. Describe how your participation in the KSU-LSAMP program will contribute to the program's goal of broadening participation in the sciences and the future of the discipline Application Due on January Submit Application to: STEM/LSAMP Office, Dept of Biology and Physics, Rm 300 College of Science and Mathematics ATTN: Dr. PN Achar- pachar@kennesaw.edu Or Sigurdur Greipsson- sgreipss@kennesaw.edu