Last or Family Name(s) / First Name / Middle Name / Maiden Name
Date of Birth (mm/dd/yyyy) / Gender
□ Female
□ Male
□ No Response / Will you be the first person in your immediate family to attend a college or university?
□ Yes □ No □ No Response
Are you a U.S. Citizen?
□ Yes □ No
If no, are you a Permanent Resident of the U.S.?
□Yes □ No Alien Resident No. ______/ Ethnicity
□Hispanic/Latino
□ Not Hispanic/Latino
□ No Response
Race
□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ Native Hawaiian or Pacific Islander
□ White
□ No Response
Are you a veteran of the US Armed Forces?
□Yes □ No branch ______
Do you have a disability? □ Yes □ No □ No Response

Current Address

Street
City / State / ZIP/Postal Code / Country
Home Phone / Office or Cell Phone
Primary E-mail Address (Very Important) / Alternate E-mail Address

Permanent Address (if different)

Street
City / State / ZIP / Country
Home Phone

Education

University/College/Institution (Current Enrollment) / Major Field of Study / Minor Field of Study / Overall Grade Point Average (GPA)
Are you currently enrolled in the Ira. A Fulton Schools of Engineering? □ Yes □ No
Date of Enrollment (mm/yyyy) / Expected Date of Graduation with Bachelor’s Degree / Are you currently enrolled in courses for the Spring of 2017? □ Yes □ No
Academic Year: □ Freshman □ Sophomore □ Junior □ Senior
Career experience prior to attending college (use a separate page if necessary):
List other colleges or universities you have attended, if any:

(Attach a separate sheet if necessary)

Please limit each response to no more than 300 words.

Why do you want to participate in this REU?

Why do you want to do research and why do you think you might be good at it?

What are your academic and career aspirations and goals? How might participating in this REU help you achieve them?

Have you participated in REUs/research programs in the past? If so, where and in what?

Is there anything else you would like to tell us about yourself?

How did you learn about us?

Include one letter of reference in your application.

Program Commitment and Signature:

I certify that all parts of this application packet are complete and accurate to the best of my knowledge, and I understand that submission of inaccurate information may be just cause for denial of admission or termination of enrollment.

Upon acceptance into the Solar Energy Research Experience for Undergraduates, I will participate fully in all program activities with a full-time commitment throughout the session from the date of my arrival until the end of the program. Failure to do so may be sufficient cause for QESST/ASU to decrease or cease payment of my stipend, or terminate my enrollment in the program

Signature: ______Date: ______

Solar Energy REU ▪ Tiffany Rowlands

Quantum Energy and Sustainable Solar Technologies (QESST) ▪ Arizona State University

PO Box 875706 ▪ Tempe, Arizona 85287-5706 ▪ (480) 965-5936 ▪