APPLICANT NAME

Last name:

First name:

ID NUMBER

Applicant ID Number

To correctly link all documents associated with this submission applicants should select and record a unique number or character string to serve as your ID NUMBER. Application ID must meet the following requirements:

Contain at least one letter (upper or lower case)
Contain at least one number (0, 1, 2, 3, 4, 5, 6, 7, 8, or 9)
Contain at least one special character ($, @, %, #, +, or !)

You must use this same ID NUMBER on all application documents (application form, cover letter, letters of recommendation) linked to this submission.

Beginning: 27 May 2007  |  Concluding: 4 August 2007

If you can not be in full attendance during the entire time the program is in-session, record dates missed and reason here:

NAME

Last name:

First name:

Middle name:

CURRENT MAILING ADDRESS

Street address:

City:

State:

Zip code:

Country:

NOTE: At this location until:
Record format as: day / month / year (e.g. 15 / September / 2007) - or - PERMANENT

CURRENT CONTACT INFORMATION

Day/cell telephone number:

Evening/other telephone number:

Fax number:

E-mail address:

GENDER

PERMANENT ADDRESS (if different from current)

Street address:

City:

State:

Zip code:

Country:

CURRENT ACADEMIC AFFILIATION

Name of school currently attending:

City:

State:

Country:

ACADEMIC ADVISOR

Name:

Telephone number:

E-mail address:

CITIZENSHIP

___ United States

If US citizen, record your STATE of residence:

___ Foreign

If not a US citizen record your COUNTRY of citizenship:

CURRENT ACADEMIC LEVEL

___ Community College
(any level)

___ College-level Freshman
(first undergraduate year)

___ College-level Sophomore
(second undergraduate year)

___ College-level Junior
(third undergraduate year)

___ Non-graduating College Senior
(fourth undergraduate year)

___ Graduating College Senior
(final stage of undergraduate education)

Anticipated month of your graduation:

Anticipated year of your undergraduate graduation:

___ Graduated
(completed undergraduate degree)

Year graduated:

___ Other, (please specify)

ACADEMIC MAJOR(S) / MINOR(S)

Academic major:

Second major:

Academic minor:

Second minor:

GRADE POINT AVERAGE (GPA)

Overall college GPA:

based on a scale of:

Freshman/Sophomores

High School GPA:
based on a scale of:

Juniors/Seniors/Others

GPA in Major:
based on a scale of:

Students at schools not issuing grades, or at institutions whose system does not fit this reporting scheme, are encouraged to offer a short descriptive of their institutions grading scheme.

 

 

NATURAL HISTORY SCIENCE UNIT

Select the ONE natural history discipline that best categorizes your research interests and background.

__ Anthropology
__ Botany
__ Entomology
__ Invertebrate Zoology
__ Mineral Science & Geology
__ Paleobiology
__ Vertebrate Zoology - Amphibians & Reptiles
__ Vertebrate Zoology - Birds
__ Vertebrate Zoology - Fish
__ Vertebrate Zoology - Mammals

ADVISOR / SUPERVISOR SELECTION

Record the name of the Smithsonian advisor/supervisor with whom you most want to work with as a participant in this internship program.

Preferred Advisor

Will you accept a position working with someone other than the person identified as your first choice?

If yes, list three alternate advisors/supervisors whose research also interests you as a topic for this program.

Second choice:

Third choice:

Fourth choice:

CAREER GOALS
Briefly state your career goals including education, research, and job/career aspirations. Limit your answer to no more than four sentences.

SKILLS
List your computer, technical, equipment, laboratory, field, and language skills and techniques. Limit your listing to no more than 15 entries.

ACADEMIC ACHIEVEMENTS
List your academic achievements, honors, and awards. Limit your listing to no more than 10 entries.

COURSES and GRADES
Send separately a copy of your transcripts - OR - list here all courses taken, and grades earned, that are relevant to this application.

EXPERIENCE / BACKGROUND
Record your relevant experience such as previous internships, volunteer appointments, organization memberships, independent research experience(s), etc.

ADDITIONAL INFORMATION
OPTIONAL: List here specific details not already addressed, relevant to the review of your application.

FIRST REFERENCE

NAME

Last name:

First name:

Middle name:

MAILING ADDRESS

Street address:

City:

State:

Zip code:

Country:

CONTACT INFORMATION

Day/cell telephone number:

Fax number:

E-mail address:

PROFESSION

__ University/College Professor
__ Science Educator
__ Administration
__ Other, please specify:

RELATIONSHIP TO APPLICANT

__ Academic Advisor
__ Teacher
__ Employer
__ Personal Friend
__ Other, please specify:

NAME

Last name:

First name:

Middle name:

MAILING ADDRESS

Street address:

City:

State:

Zip code:

Country:

CONTACT INFORMATION

Day/cell telephone number:

Fax number:

E-mail address:

PROFESSION

__ University/College Professor
__ Science Educator
__ Administration
__ Other, please specify:

RELATIONSHIP TO APPLICANT

__ Academic Advisor
__ Teacher
__ Employer
__ Personal Friend
__ Other, please specify:

1. Do you consider yourself disabled or having an impairment?

If yes, select one:

__ Hearing Impairment
__ Visual Impairment
__ Mobility Impairment
__ Other

You can also define or qualify your answer here:

2. Do you consider yourself a US ethnic minority?

If yes, select one:

__ Alaskan Native American
__ African American
__ Asian American
__ Hispanic American
__ ative American
__ Native Hawaiian
__ Other *You can also specify your tribal affiliation or otherwise qualify your answer here:

3. How did you find out about this program?

Check all that apply

__ Heard about it from a friend
__ Heard about if from RTP alumni
__ Heard about it from a professor
__ Saw the paper recruitment poster
__ Saw the listing in SORS booklet or SORS web posting
__ Found it on the NSF web posting of REU sites
__ Found it on another web listing
__ Found it on a web search

4. If we can't place you in our program this year would you like us to share your interest in a summer research program, and your contact information, with other programs seeking interns for this summer?

How to Submit

E-MAIL TO: sangreym@si.edu

FAX TO: 202-786-0153

MAIL TO: Research Training Program 10th Street & Constitution Ave., NW NHB MRC 106, Room 59A PO Box 37012 Smithsonian Institution Washington, D.C. 20013-7012 U.S.A

If you have questions, contact Mary: Phone: 202-633-4548  |  E-mail: sangreym@si.edu

Research Training Program
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