The TIM REU Consortium

Personal Information: 2013 Summer Chemistry Research Fellowship Application

The form and your answers may be sent to any of the listed faculty participating in this program.

"Please note that information provided in this application may be used to report statistics to the National Science Foundation or other reporting agencies in an aggregate report. All information provided will remain confidential."

Personal and contact information
1. First Name:
2. Last Name:
3. Are you a U. S. citizen or permanent resident?
4. Gender?
5. Ethenic Background? (This field is not required but provides important information utilized in the research results reported to the NSF)
6. Email Address
7. Phone number where you can be reached after classes end in Spring 2011
8. Address where you can be reached after classes end in Spring 2011
9. Your Current School
10. Current year in school?
11. Expected Date of Graduation
12. List the chemistry courses you have taken, including those you are currently enrolled in
13. continue listing courses here
14. What is your career goal?
15. What do you hope to gain from a summer research fellowship?
16. Where would you like to participate?
Rank the schools from 1-6 (1 first choice).
You can leave blanks.
Colby College
Grand Valley State University
Macalester College
Northern Kentucky University
Trinity University
University of San Diego
Please send this application and have a copy of your transcript and two letters of recommendation sent by March 15, 2013

The above materials or inquiries may be sent to
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