Bringing Next-generation Sequence (NGS) Analysis
Into Undergraduate Education
Applicant Information
Selection of Working Group members is based on the applicant’s potential to develop an effective RNA-Seq
dataset and use it as the basis for student research projects during the 2014-15 school year.
Complete this Applicant Information form (please type or write legibly) and submit it together with Proposal
Narrative and Institutional Support Letter by April 1 to:
RNA-Seq Working Group Application
DNA Learning Center
Cold Spring Harbor Laboratory
1 Bungtown Road
Cold Spring Harbor, New York 11724
Fax: (516) 367-5182
NAME
________________________________________________________________________
Last
First
MI
Dr./Mr./Ms.
SCHOOL
________________________________________________________________________
ADDRESS
________________________________________________________________________
Number and Street
City
____________________________________________________________________________________
State
HOME ADDRESS
Postal Code
(( (Area Code) Telephone
School e-mail address
__________________________________________________________________
Number and Street
City
____________________________________________________________________________________
State
Postal Code
Please check your gender:
Female
(Area Code) Telephone

Male
Home e-mail address


Please check the group that best describes your ethnic/racial status:
Please check your age group:

American Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic Origin
Hispanic
White, not of Hispanic Origin
Do not wish to respond







Under 30
31-45
46-50
51-55
56-60
Over 60
Percentage of disadvantaged and underrepresented minority students at your institution: _____
Percentage of disadvantaged and underrepresented minority students in biology classes: _____






Professional Qualifications and Teaching Experience (continue on back, if needed)
Academic degree(s) and major(s):
_____________________________________________________
Additional training: ___________________________________________________________________
Total number of years teaching:
Current position:
________________________________________________________
_________________________________________________________________
Courses taught in school years 2011-2013:
Current teaching assignments for 2013-14:
Special positions or responsibilities within the department, e.g., chair, committee membership:
Participation in curriculum development or student enrichment programs:
Active involvement in professional societies and/or other extracurricular educational activities:
Experience with bioinformatics:
Experience mentoring undergraduate student research:
Publications with undergraduate student authors (underscore student names):