FSSEP Application Information

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What is the Food Science Summer Enrichment Program, FSSEP?
FSSEP is an intensive week long program that is designed to help students develop a better understanding of science
through experiential activities in Food Science that are linked to the Sunshine Standards. It will run from July 9th to
13th, 2012 from 8:30 a.m. to 4:30 p.m.
Learning Objectives
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Students will learn about food science career opportunities, meet with food science representatives from
industry, government and academia and develop research presentation skills
Become familiar with simple lab equipment
Recognize that the strength or usefulness of a scientific claim is evaluated through scientific argumentation,
which depends on critical and logical thinking, and the active consideration of alternative scientific
explanations to explain the data presented
Describe how scientific inferences are drawn from scientific observations and provide examples from the
content being studies
Eligibility
Students who have completed 7th through the 9th grades with an interest in the sciences and/ who would like to
improve their laboratory skills and learn about food science and the food industry.
Cost
There will be a $100 entry fee for each student.
Meals:
No meals are provided and each student will be responsible for bringing their meals. Every student must bring an
appropriate lunch or money for his/her lunch each day to the program.
Location & Time
Florida A & M University, College of Agriculture and Food Science Perry-Paige Building, Food Science Lab Room
102S and the Teleconference Center from 9:00a to 4:30p, Monday-Friday
Contact Information
Mrs. Connie Newman, Coordinator
850-561-2616
Dr. Neil James, Professor
850-561-2310
Dr. Mitwe Musingo, Professor
850-561-2309
Food Science Summer Enrichment Program
Application Requirements
Application Deadline
The application deadline for the 2012 FSSE program (July 9-13) is June 25, 2012.
All applications will be reviewed by the Food Science Program and selection decisions will be
based on the grades, application essay, letters of recommendation, and demonstrated interest
level. Successful applicants will be contacted by Friday, June 29, 2012.
Completing the Application
A complete application must include:
 Application Form
 Application essay: topic – The role of science to my future.(Essay must be typed with a
12 point font, single spaced and not exceed one page with 1 inch margins no longer than
one page, single spaced)
 Transcript/Report Card
 (2) Letters of Recommendation
Submitting the Application
The application and supporting documents must be received by the June 25th
application deadline. Applications may be received electronically as PDF files. Please scan the
completed application form and transcripts and send them, along with your application essay, to
Mrs. Conchita Newman, conchita.newman@famu.edu. If mailing your application and
supporting documents, please, do not staple any pages and mail to:
Mrs. Conchita Newman
FSSEP Coordinator
FAMU Food Science Program
102 S. Perry-Paige Building
Tallahassee, Fl 32307
If you have questions, please contact:
Conchita Newman, conchita.newman@famu.edu
850-561-2616
Please feel free to visit the college website for additional information:
http://www.famu.edu/cesta
Florida A & M University
College of Agriculture and Food Sciences
Food Science Summer Enrichment Program
Summer 2012 Application
July 9 – July 13
Personal Information
Name:
Last
First
Middle
Permanent Address:
E-mail:
Phone:
Home
Cell
Date of Birth:
Gender: Male
Female
Health Conditions
Do you have any physical disabilities that may affect your participation in FSSEP?
If yes, please explain:
Are you taking any prescribed medication(s)?
If yes, please list:
Yes
Yes
No
Education
Name of High School:
Address:
City, State, Zip:
Counselor’s Name:
Current Grade Level:
Telephone#:
GPA:
Application Deadline: June 25, 2012
The application form and all supporting documents must be received by the deadline!
No
Florida Agricultural and Mechanical University
TALLAHASSEE, FLORIDA 32307–3100
______________________________________________________________
Environmental Health and Safety
Phone: 850-599-3442
Fax: 850-599-8024
Florida A&M University – Medical Consent and Liability Release
This is a legal and binding agreement which, when signed, will permanently limit your ability to recover from the
parties indicated below for injuries or losses you may sustain as a result of participation in Summer Camp or
Summer Academic Program activities.
References to Florida A&M University (henceforth referred to as FAMU) include Florida A&M University, acting by
and through its Board of Trustees, the Florida Board of Governors, the State of Florida, its agents, officers, faculty
and employees.
PLEASE READ CAREFULLY.
MEDICAL CONSENT FORM
I hereby grant permission for emergency medical service to be rendered as deemed necessary to my child (or
myself). I do hereby voluntarily consent and authorize FAMU, in the event of an accident, illness or injury to take
whatever measures and actions considered necessary and warranted under the circumstances to protect,
safeguard and minimize further injury, health and safety. I understand that such actions may involve or require
placement in a hospital or another medical facility for services and treatment. Any transportation expenses by any
mode will be a debt and liability for which I accept total responsibility.
I hereby further declare, represent and agree, that in the event that FAMU has to exercise the above voluntarily
given medical authorization and consent, that I hold harmless, release and forever discharge FAMU from any and
all liability, damages, claims and demands whatsoever, including attorneys fees and court cost, which the
undersigned, any heir or assigned has made.
Finally, I hereby declare and represent that I have read this statement, understood its contents, execute it of my
free will and choice, and agree to be legally bound by it.
Initial __________
CONTINUE WITH NEXT SECTION
LIABILITY RELEASE
By signing this MEDICAL CONSENT and LIABILITY RELEASE, I assume any and all liability for any accident, injury,
illness, damages or loss that may occur during participation or as a result of Summer Camp Activities at FAMU.
In consideration for the acceptance into or voluntary participation in the above stated activity/event, I/We
hereby release, waive and discharge any and all demands and claims for, but not limited to, damages,
personal injury, property damage, illness, death or loss which I may have or which hereafter accrue to
me, against FAMU due to participation in or as a result of the above mentioned activity/event. This
release will discharge and hold FAMU harmless from and against any and all liability and demands
(including attorney fees and court cost) arising out of or connected in any way with participation in or as a
result of the above mentioned activity/event, even though that liability may arise out of negligence on the
part of persons or agencies mentioned above.
I/We further understand that damages, accidents, injuries or death could arise out of participation or as a
result of the abovementioned activity/event. Knowing this, I hereby agree to assume those risk and to
release and hold all agencies and persons mentioned above harmless who (through negligence or
carelessness) might otherwise be liable to me.
I/We fully understand and agree this disclaimer, release, waiver and assumption of risk, is to be binding
on my heirs and assigns.
I HAVE READ THIS ENTIRE RELEASE. I FULLY UNDERSTAND IT AND AGREE TO BE LEGALLY
BOUND BY IT.
_______________________________________________
Print Name of Minor or Participant (if under 18 years old)
__________________
Minor’s Date of Birth
_______________________________________________
Print Name of Parent, Legal Guardian or Custodian
_______________________________________________
Print Name of Participant if 18 years or older)
_______________________________________________
Signature of Parent, Legal Guardian or Custodian
__________________
Date
_______________________________________________
Signature of Participant if 18 years or older
__________________
Date
________________________________________________________________________
Address
________________________________________________________________________
Phone Number (s)
Emergency Contact, Other than parent(s) or legal guardian(s):
_______________________
Name
___________________________
Relationship
_______________________
Signature
___________________________
Date
_______________________
Home Phone
___________________________
Work/Cell Phone
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