Department of Chemistry Summer 2002 Undergraduate Research Assistantships & Research Experiences for Undergraduates Program Application

Department of Chemistry

SUMMER 2002 UNDERGRADUATE RESEARCH ASSISTANTSHIPS

RESEARCH EXPERIENCE FOR UNDERGRADUATES PROGRAM

June 3 - August 9, 2002
APPLICATION FORM

(DEADLINE: March 1, 2002)

Last Name, First Name		Social Security
Undergraduate Insitution		Expected Graduation
Major		Prior Research Exp	Yes No
Campus Address		Campus Phone-Days
		Campus Phone-Eves
		E-Mail
Permanent Address		Last Day on Campus
		Permanent Phone


PREFERRED AREAS OF RESEARCH INTEREST (Select one)
	Analytical Chemistry Organic Chemistry
	Biological Chemistry Physical Chemistry
	Inorganic Chemistry

REFERENCES (Use the reference forms to request letters from two faculty members who best know your academic and research work. List these individuals here as well)
Reference 1		Reference 2
Name		Name
Title		Title
Department		Department
Institution		Institution
Phone		Phone
E-Mail		E-Mail

I hereby certify that all of the above information is correct and true.
Signature		Date
I hereby grant the NSF-REU program permission to use the above information for statistical analysis purposes only, with the proviso that no personal information will be released to anyone besides those few, qualified researchers doing the statistical analysis and that these researchers will only report/publish aggregate statistics. Your willingness to participate in this statistical survey may help ensure the continued growth and vitality of this Federally sponsored program.
Signature		Date

CENSUS QUESTIONS
Mandatory Census Questions
Date of Birth	Gender Female Male	Citizenship
Optional Census Questions
Group
African American	Caucasian Hispanic Native American Pacific Islander	Other (name)
I chose to skip this question
Challenges
Auditory Motor	Visual	Other (name)
I chose to skip this question

ADDITIONAL MATERIALS
List of all courses that you are taking in the current term
Statement of academic interests and career goals. This statement should be 250-500 words long. Include your intentions regarding post-baccalaureate programs (graduate school, medical school, MD-PhD program, or other). Also include details of any previous research experience, although prior research experience is not a pre-requisite for this program.

In addition to the online form, you must also submit:

Two letters of reference from academic faculty. These letters must be sent from the two persons named above directly to the Program Director. The printable reference forms are available at: http://www.chem.pitt.edu/reu/reu02/reference_02.html or http://www.chem.pitt.edu/reu/reu02/reference_02.pdf.
An official transcript. This should include Fall 2001 grades.

SUBMISSION DEADLINE: March 1, 2002

Submit to:	Questions or Problems
Prof. Joseph J. Grabowski
REU Program Director	Contact Prof. Grabowski at:
Department of Chemistry	Phone: (412) 624-8632
University of Pittsburgh	Fax: (412) 624-8611
Pittsburgh, PA 15260	E-mail: joeg@pitt.edu

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