Application Form 2006

PERSONAL INFORMATION:

Name_____________________________________________________________

Address at school _________________________________________________

Permanent address _________________________________________________

Email ____________________________________________________________

Phone (school) ____________________________________________________

Phone (home) ____________________________________________________

Are you a [ ] US citizen or [ ] permanent resident (at the time of this application)?

(Note that only US citizens or permanent residents are eligible for the National Science Foundation REU program.)

 

PERSONAL STATEMENT:

1. Describe your motivation for participating in this program.

2. Describe your research experience and research interests (what kinds of problems do you like to work on).

3. Describe your academic and career goals.

4. How do you expect this REU experience to impact your education and career? 

5. Do you currently plan to attend graduate school? (what school/major/degree)

 

EDUCATION BACKGROUND:

College(s) attended _______________________________________________

Major ____________________________________________________________

Class as of September 1, 2006:

[ ] sophomore [ ] junior [ ] senior

Expected graduation date _________________________________________

(Expected graduation must be later than August 2006)

GPA _____________________

GPA in major ___________________

 Home Institution's highest degree granted in fields supported by NSF (associate's degree, bachelor's degree, master's degree, doctoral degree):______________________________

TRANSCRIPT:

Please make sure to include a transcript.  Both official and unofficial transcripts will be accepted.  Make sure to include the transcript along with the application form.

 

PROGRAMMING BACKGROUND AND EXPERIENCE:

Please list courses taken, programming languages known, and any other relevant information.

 

 

REFERENCES:

Name of first faculty recommender _________________________________

Email of faculty __________________________________________________

Name of second faculty recommender ________________________________

Email of faculty __________________________________________________

(Recommendations should be mailed separately by faculty members to the address at the bottom of this page)

 DEMOGRAPHIC INFORMATION*:

Gender: (choose one)
      Male
      Female 
 

Ethnicity: (choose one)
        Hispanic or Latino
        Not Hispanic or Latino
        Unknown
 

Race: (select one or more)
        American Indian or Alaskan Native
        Asian
        Black or African American
        Native Hawaiian or Pacific Islander
        White
 

Disability Status: (select one or more)
     Hearing Impairment 
     Visual Impairment 
     Mobility/Orthopedic Impairment 
     Other 
     None 
First-generation college students: (choose one)
_Yes
_No

* Submission of demographic information is voluntary. 

ALL APPLICATION MATERIALS (including application form, transcripts, recommendation letters) MUST BE MAILED AND POSTMARKED BY March 10, 2006.

Post applications to:
MedIX REU Program c/o Daniela Stan Raicu, Assistant Professor
DePaul University

School of Computer Science, Telecommunications, and Information Systems (CTI)

Loop Campus, Office 471

243 S. Wabash Ave,

Chicago, IL 60604, USA

 

For any questions regarding the application, please email to Dr. Raicu at draicu@cs.depaul.edu or to Dr. Furst at jfurst@cs.depaul.edu

 

 

 
Webmaster Daniela Stan: dstan@cs.depaul.edu
Last modified: February 02, 2006