Applications must be postmarked no later than February 28th, 2009
Late
applications will be considered if we have space remaining in the program.
Name SS
or ID# ______
Last First MI
Mailing
Address ______
( ) ______
City State Zip Phone
Permanent
Address ______
( ) ______
City State Zip Phone
E-Mail Address Primary ______ Other
College or University Major ______
Cumulative GPA: Expected Graduation Date: Month ______Year ______
Do you plan to attend graduate school? M.S. Ph.D. M.D. Other
No Unsure
List Employment Record (if any; begin with current):
Employer Dates Position Nature of Work
______
______
Academic Honors or Awards ______
If program dates conflict with your academic
schedule, what dates would you be available? ____________
Applicant’s checklist:
·
This application
·
Official transcript of your academic record
·
Two reference letters
· Brief narrative that discusses your interest in this
program, and your long-term career goals
Please provide a feel for your background and your interest in research - what projects have you been involved with in the past if any; do you prefer experimental or theoretical work. Applications from students who are members of underrepresented groups are strongly encouraged.
Optional: Ethnicity Gender
I certify that all information is valid and true to
the best of my knowledge.
__________________
Signature of Applicant Date
Send Application Materials to:
2009 REU Site Program
c/o Prof. C. G. Takoudis
Department of Bioengineering
SEO 218
[Fax: (312) 413-4700; e-mail:
reunsf@uic.edu]
The