| Name (Last, First, MI): | |
| Email Address: | |
| Country of Citizenship | |
| Address (Street, City, State, Zip) | |
| Telephone Number (Area code + 7 digits) | |
| High School, City, State | |
| Undergraduate College / University | |
| Current major | |
Current year in school
| Freshman
Sophomore
Junior
Senior
|
| Expected Graduation Date | |
| Overall GPA | |
Gender
| Female
Male
Do not wish to report
|
Ethnicity
| Hispanic or Latino
NOT Hispanic or Latino
Do not wish to report
|
Race (please check all that apply)
| Alaska Native
Asian
Black or African American
Native American
Native Hawaiian or Other Pacific Islander
White
Unknown
Do not wish to report
|
Disability Status
| Hearing Impairment
Visual Impairment
Mobility or Orthopedic Impairment
None
Other
Do not wish to report
|
Citizenship
| U.S. Citizen
Permanent Resident
Temporary Resident
|
Are you part of an LSAMP Program at your home institution? LSAMP is the NSF Funded Louis' Stokes Alliance for Minority Participation.
| Yes
No
|
Previous research experience (outside laboratory courses)
| None
Less than 50 hours
More than 50 hours
|
Plans for graduate / professional degree
| None
MS
PhD
MD
Other
|
Specific area of interest in graduate / professional school (e.g. ME)
| |
| Have you previously conducted research with a faculty member at another academic institution? If so, who and where and what was your research topic? | |
Have you previously conducted research with a faculty member at the Center for Compact and Efficient Fluid Power, if so, who?
| |
| Are there any other factors that should be considered when placing you in a specific laboratory or research experience? | |
Indicate each REU location that interests you.
| GATech
MSOE
NCA&T
Purdue
UIUC
U of MN
Vanderbilt
|
Please submit a one Paged Typed Cover Letter indicating your interest in fluid power, why you should be selected to participate in the CCEFP REU Program.
| |
Please submit a current resume
| |
| Names, titles and email addresses of your references | |
|