Noyce Summer Scholars Program: June 3-August 9, 2013

First Name:
Last Name:
E-mail:
Date of Birth (MM/DD/YYYY):
Citizenship:
Current address:
Permanent address:
Current telephone number:
Permanent telephone number:

Current college/university:
Major:
Expected date of graduation (MM/YYYY):
Overall GPA (out of 4.0):
GPA in science/math:

Previous college(s) attended, with dates:


Would you like to conduct research with a specific professor or department?

Do you prefer certain research areas or projects?

Please list names and e-mail addresses of at least two people who have agreed to send letters of recommendation. At least one should be a science professor. You may provide an optional third name if you wish. Please ask these recommenders to submit their letters to noyce@uvm.edu
Name E-mail
1.
2.
3.

If you have a conflict with the program dates, when are you available in summer 2010? (MM/DD/YYYY)


The following information is collected only to comply with NSF requirements and will not be used for selection.

Ethnicity:
American Indian/Pacific Islander
Asian
Black
Caucasian, non-Hispanic
Hispanic
Other:

Gender:
Female
Male
Other


How did you first learn of the Noyce Summer Scholars Program?
Campus advertising
Professor or advisor
Friend or classmate
List of summer programs (specify below)
Other (specify below)

If you need to elaborate on any of your answers, please do so here.

After submitting this form, send a transcript (unofficial copy printed from MyUVM is okay) and a personal statement of no more than 500 words about your research interestes, any prior research experience, and career aspiriations to noyce@uvm.edu with your last name in the subject line.