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Neuroscience REU Application

Personal Information

Name

First

Middle

Last

Mailing Address

Country

First name

Last name

Company

Street address

Street address line 2

City

Postal code

Email Address

Current phone number

Gender

Enter other…

Date of Birth

Date format varies due to browser rendering quirks

Chrome & Firefox: mm/dd/yyyy
Safari: yyyy-mm-dd

Race/Ethnic Group

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

Hispanic or Latino/Latina

White

Decline to Answer

Citizenship

Reported to federal/state agencies to evaluate civil rights compliance.

U.S. Citizen

Non-U.S. Citizen

If not a US citizen, are you a permanent resident of the US?

First-Generation College Status: Has either of your two primary guardians earned a bachelor’s (or equivalent) degree from an accredited college or university?

Yes

Academic Information

Current Institution Attending

Current student classication (as of May of the current year)

Expected graduation date (mm/yy)

Expected graduation date (mm/yy): Year

Expected graduation date (mm/yy): Month

Current cumulative grade point average (out of 4.0)

Primary area of research interest

Top Choice Faculty Mentor

Second Choice-Faculty Mentor

Third Choice-Faculty Mentor

If none of your preferred mentors are available, would you consider being placed with another mentor?

Personal Statement and Transcripts

Transcript(s)

Maximum 3 files.
5 MB limit.
Allowed types: pdf, doc, docx, .

Personal Statement

One file only.
2 MB limit.
Allowed types: pdf, doc, docx, .

Letter of Recommendation

1st Recommender

Title

Enter other…

First

Last

Department/Institution

Email Address

Waive Right

Under the provisions of the Family Educational Rights and Privacy Act of 1974, I hereby waive my right to inspect to the recommendation given above.