On-line Application Form

The deadline for completion of an application packet is March 31, 2007. Acceptances will be announced beginning mid-April, and applications will continue to be accepted until all positions are filled.


Personal Information

Title: Last name: First name: M.I.:
Social Security number:
Citizenship status:
E-mail address:
Please re-enter your e-mail above address to confirm:

Current address at school:
Street or dormitory:
City: State: ZIP:
School phone number (incl. area code):

Home address:
Street:
City: State: ZIP:
Home phone number (incl. area code):

College/University Information
[You must attend a U.S. institution to participate in this program.]

College or university currently attending:
Other universities attended:

Academic classification at the beginning of fall term f:
Degree seeking:
Major: If 'other' selected, please enter major here:
Minor:
Expected date of graduation:

Your summer availability in 2007 (format MM/DD/YYYY) from until

Career or education plans after graduation (you may copy and paste text only from a word processing document):


Why would you like to participate in this program (you may copy and paste text only from a word processing document)?


Have you had any experience in a science research program?
If 'yes,' please give type, description of the research and name of research director:

Please indicate your top two choices of research fields.
First choice:   

Second choice: 

Academic information

Please give course name, credit hours granted and grade received for each course listed below.
Physics lecture courses:

Physics laboratory courses:

Other science courses:

Math courses:

Grade point averages (0-4 scale)
Physics: Other science courses: Math courses: Overall GPA:

The following information is optional and its omission will in no way jeopardize consideration of your application.
Gender: Ethnic group:

References

Two references are required.
Please do NOT use all CAPITAL letters in addresses!

Reference #1:
Title: First name: Last name:
Department:
School, College or University:
Street address: City:State: ZIP:
Telephone number (incl. area code): FAX number (incl. area code):
E-mail address:

Reference #2:
Title: First name: Last name:
Department:
School, College or University:
Street address: City: State: ZIP:
Telephone number (incl. area code): FAX number (incl. area code):
E-mail address:

Important! Please review your application now.

Do NOT press the 'Submit' button until the form has been COMPLETELY filled out.