REU Application Form

Application deadline is March 3, 2010

Please note that information provided in this application may be used to report statistics to the National Science Foundation or other reporting agencies in an aggregate report. All information provided will remain confidential.


First name:
Last name:
Email address:
What is your citizenship?
Date of birth:
Place of birth:
Your school address:
Your permanent address:
Name of parent or guardian:
Parent or guardian address (if different than above):
School phone number (2010):
Home phone number:
Cell phone number:
Name of high school and year of graduation:
Undergraduate institution:
Major:
Expected date of undergraduate degree:
Expected status in fall 2010:
Cumulative GPA:
GPA in chemistry coursework:
List all other colleges attended:
Date GRE was taken, or will, be taken:
Date MCAT was, or will, be taken:
List all college courses taken in chemistry, physics, and math and grades received:

Provide the name, address, phone number and email address of two chemistry faculty you have asked for a recommendation:

If chosen to participate in the REU program what are your summer housing plans?

This section will be an important part of the selection process. Briefly discuss the following:

First choice of research projects:
Second choice:
Third choice:

What are your plans for future professional or graduate education and career goals?

How will the summer REU experience contribute to your career goals?

Pick a category that describes your ethnic/racial status:

Submit application: