Natural Science Summer Research
Application

Today’s Date:

Name:

Student ID#: SSN (last 4 digits only):

Year (Fresh, Soph, Jr, Sr):

Email (required):

Cell Phone (required): Home Phone/Campus Ext:

Campus Address:

Home Address:

City: State: Zip:

Person to be notified in an emergency:

Address of the above with day, evening and cell phone numbers:

ACADEMIC INFORMATION

Academic Major: Minor:

Advisor:

GPA (in Major): Overall GPA:

At time of application (not including current semester)

number of credit hours completed AT Benedictine University:

Expected Date of Graduation:

With which faculty research supervisor would you like to work? Before making your selection, please consult with faculty member you are selecting. If the faculty member you are selecting has multiple projects, please indicate the project number you would like to work on.

First choice and project #:

Second choice and project #:

Third choice and project #:

If chosen, will you require housing on campus? (Yes/No)

Please see instructions if you are requesting housing. Contact Rose Fisk at prior to the application deadline. A justification must be provided to qualify for housing.


Is there a time period (longer than five days) between June 1 – August 15 when you would not be able to participate? (Yes/No) If Yes, what dates:

Reason:

List other summer work positions for which you are applying.

Please provide the following information for EACH EMPLOYER:

Institution/Company, Department, Job description.

Please briefly respond to the following questions:

1. Describe coursework, experience, etc. pertinent to your research selection.

2. Describe present and long-term aspirations clearly and succinctly (100 words or less).

3. Describe the relationship of this Summer Student Research Program to your career plans, e.g. how do you think a summer research experience would aid you as you work toward these goals (100 words or less).

4. Please list what you consider your strengths and weaknesses.

Please save a copy of your completed form for your records.