Last or Family Name(s) / First Name / Middle Name / Maiden Name
Social Security Number / Date of Birth (mm/dd/yyyy) / Ethnicity
□Hispanic/Latino
□ Not Hispanic/Latino
□ No Response
Gender □ Female □ Male □ No Response / Race
□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ Native Hawaiian or Pacific Islander
□ White
□ No Response
Are you a U.S. Citizen?
□ Yes □ No
If not a U.S. Citizen, are you’re a Permanent Resident of the United States?
□Yes □ No Alien Resident No. ______
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 2015?
□ Yes □ No
List other colleges or universities you have attended, if any:

Solar Energy Research Experience for Undergraduates

(Attach a separate sheet if necessary)

Please limit each response to no more than 300 words.

Why are you interested in electrical engineering and/or materials science?

What is your experience with solar energy and photovoltaics?

What are your goals for participating in the Solar Energy Research Experience for Undergraduates?

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

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 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 ▪