High School Summer Research Program Application

Thank you for your interest in becoming a high school researcher with CIBER and the support of the National Science Foundation EPSCoR program. The National Science Foundation (NSF) is one of the major US federal agencies that funds basic and applied science research, and research experiences for students. NSF has funded a program in Delaware, the Delaware EPSCoR program, as a partnership among the University of Delaware, Delaware State University, Delaware Technical Community College and Wesley College. The Delaware EPSCoR program supports university faculty researchers, buys research instrumentation, with a particular emphasis on environmental science and life science research.

Eligible internship applicants are rising high school students with a minimum 3.0 GPA at the time of application.

Application Criteria:

Students must have completed the 8th grade to be eligible for participation.
Students should have successfully completed Biology, Chemistry or Physical Science prior to participation.

This is not a residential program and students are responsible for providing their own transportation to their work assignment.

How to Apply for the Summer Research Internship:

Complete the application form below.

Please be prepared to attach a copy of your most recent transcript, or a listing of your college-level science or math courses, along with the grades you received in each. An unofficial transcript is fine. If you have trouble uploading your transcript, you can email a copy to :

Delaware State University – Contact:
Laurieann Phalen, Senior Secretary - Center for Integrated Biological and Environmental Research.

Phone: 302-857-6453
Email: Lphalen@desu.edu

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* 1. Today's Date

Date

Personal Information

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* 2. Personal Information

Name *

Address *

Address Line 2 (optional)

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Mobile Phone Number

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* 3. Gender

Male

Female

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* 4. Are you citizen of the United States?

Yes

If 'No', (please specify which country)

High School Information

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* 5. What year of high school will you or did you complete this year?

Freshman

Sophomore

Junior

Senior

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* 6. What is your High School's Address?

School Name

Address

City, State

ZIP Code

Question & Answer Section

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* 7. What are your scientific interests? What career or educational directions are you considering for the future?

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* 8. Have you participated in a research internship or science camp/program before? If so, briefly describe the research involved, and provide the name of the researcher for whom you worked.

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* 9. If accepted into the HSSR program, which of the following disciplines would be your first, second and third choice.

Chemistry

Molecular Genetics

Aquaculture/Environmental

Demographic Information

The National Science Foundation (NSF), sponsor of the Delaware Experimental Program to Stimulate Competitive Research (EPSCoR) Research Internships, seeks to achieve diversity in their programs. Please provide the following demographic information. This information will only be used in aggregate form for reporting purposes to the federal agencies. Thank you for your cooperation.

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* 10. Race/Ethnicity:

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 11. Disability Status:

Mobility/Orthopedic Impairment

Visual Impairment

Hearing Impairment

Other (please specify)

None of the above

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* 12. Will you be a first generation college student(Will you be the first in your immediate family to go to college ?)?

Yes

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* 13. Please upload a copy of your transcript (an unofficial transcript will suffice):

Please upload a copy of your transcript (an unofficial transcript will suffice):

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 14. Please upload a copy of your W-9 form.

W-9 forms may be downloaded from https://www.irs.gov/pub/irs-pdf/fw9.pdf

PDF, DOC, DOCX file types only.

Choose File