Department of Chemistry SUMMER 2001 UNDERGRADUATE RESEARCH ASSISTANTSHIPS RESEARCH EXPERIENCES for UNDERGRADUATE PROGRAM June 4

Department of Chemistry

SUMMER 2004 UNDERGRADUATE RESEARCH ASSISTANTSHIPS

RESEARCH EXPERIENCES for UNDERGRADUATE PROGRAM
May 31 - August 6, 2004

REFERENCE FORM

The student named below asks that you provide a brief reference report in connection with her/his application. We thank you for your time in doing so, and hope that we receive your report by the deadline for receipt of all materials: March 1, 2004.

Student's Name___________________________________________(to be filled in by applicant)

Your contact with this student:

Your overall evaluation of this student, in comparison with others at a comparable academic stage at your institution. (Please select only one.)

Outstanding
Top 5% Excellent
Top 20% Good
Top 35% About
Average Below
Average

Notable strengths:

Weaknesses:

Additional Comments (please continue on reverse if necessary, or attach additional sheets):

Signature: Date:

Your Name: Title:

Department: Phone:

Institution: E-mail:

May we contact you if clarification is needed?
_____ Yes _____ No

Please send to:
Prof. Joseph J. Grabowski
REU Program Director
Department of Chemistry
234 Chevron Science Center
University of Pittsburgh
Pittsburgh, PA 15260
Phone: (412) 624-8632 Fax: (412) 624-8611
E-mail: joeg@pitt.edu

last updated: 19 January 2004

Signature:	Date:
Your Name:	Title:
Department:	Phone:
Institution:	E-mail:
May we contact you if clarification is needed?	_____ Yes _____ No