WYOMING RESEARCH SCHOLARS PROGRAM APPLICATION FORM Incoming Freshman

(This is a fill-in form; use “Tab” or the mouse to move between fields)

Date: ______

Name: ______

(Last) (First) (MI)

Birth Date: ______

W-number/Student number: ______

Current Address: ______

Hometown/Home State: ______

Email: ______Phone number: __ - ______

(area code) (phone #)

Expected graduation date (month and year): ______

What is your major? ______

UW GPA (high school GPA for incoming freshmen): ____ Transfer GPA: ______

ACT/SAT test scores: ____

Are you in the UW Honors Program? YES NO

Are you a first generation college student? (Neither parent has a bachelor’s degree) YES NO

Are you eligible to receive Federal Pell Grants? YES NO

What is the HIGHEST degree you eventually hope to earn? ______

Once you finish your current degree program, what do you see as the IMMEDIATE next step in your career path? ______

After completing studies, I plan to work in (check all that apply):

Private Industry Nonprofit Organization Higher Education

K-12 Teaching Military Faculty

Medicine Administrative Research

State/Local Government Federal Government Other

If you indicated “other”, please explain: ______

How did you hear about WRSP? ______

Area of research interest: ______

Ig you have a faculty mentor you are interested in working with, please list their name, department, and email address: ______

Provide a statement describing the impact receiving this fellowship will have on your educational and career goals:

List any significant honors, extracurricular activities, and/or work experience:

Application Checklist:

Submit all application documents to WRSP director Jamie Crait ()

This form (completed and saved)

A 1-page essay describing your educational, career, and research goals (.doc/.docx/.pdf)

Unofficial transcripts

Your academic advisor or faculty mentor must submit a Letter of Recommendation to the WRSP by the application due date

Incoming freshman must have official high school transcripts and official ACT/SAT test scores on file with the UW Admissions Office for application to be considered.