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APPLYING TO SIU McNAIR SCHOLARS PROGRAM (Southern Illinois University-Carbondale)

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APPLYING TO SIU McNAIR SCHOLARS PROGRAM
The Ronald E. McNair Post-baccalaureate Achievement Program is a comprehensive program
structured to prepare undergraduates for successful careers as graduate students, professors, and professional
researchers. The program is an educational opportunity program funded under the Higher Education Act of
1965 collectively known as TRIO Programs. The McNair Scholars Program is funded by the U.S.
Department of Education and provides enriching educational experiences for low-income, first-generation
college students and members of underserved groups in higher education. At Southern Illinois University
Carbondale, the McNair Scholars Program accommodates twenty-eight (29) students each year. McNair
Scholars are motivated students who have both the desire and the potential to earn a doctorate degree. By
participating in the program, scholars increase and refine their academic skills as they learn tools that will
help them be successful in graduate schools.
BENEFITS:
McNair Scholars Program provides:
• Individualized academic and personal
support.
• Mentoring from faculty, graduate students
and peers.
• $2800 paid to student to conduct summer
research.
• Travel awards to participate in research
conferences and visit graduate schools.
• $200 available to mentor for research
supplies.
• Workshops on the graduate school funding
and application process.
• Participation in the McNair Summer Research
Symposium.
• Assistance in identifying and applying to
graduate schools.
• GRE Review and preparation.
Applications are accepted every Fall and Spring semester. Check our website for deadlines. Please submit the
following application materials to the McNair Scholars Office (347 Woody Hall 3
rd
level) by the end of
business (4:30pm).
After the selection committee reviews the application packets, qualifying applicants will be invited for an
interview within two weeks of the application submission deadline. Final decisions will be made within one
week following the last interview.
If you have any questions about eligibility or the application process, please contact our office.
Good Luck!
Woody Hall 347 | Mail Code 4719 900 S. Normal Avenue |Carbondale, IL 62901
Website: mcnair.siu.edu| phone: 618.453.4582|fax: 618.453.4596| email: rseymour@siu.edu
Updated 09/2019
APPLICATION REQUIREMENT CHECKLIST
(Please check these boxes off once you enclose each item with your application)
☐Completed Application (Check Only if “Completed Application”)
☐Completed Personal Statement
☐Completed Research Statement
☐Resume- including any work, leadership, and/or research experiences, RSOs, honors & awards
☐2 Letters of Recommendation, letters from faculty members with whom you had courses (preferred).
Recommendation forms can be mailed to the McNair Scholars Office (Woody Hall, Rm 347, Mail code 4719) or
placed in a signed envelope and included in your application packet.
Form can be downloaded or completed online at https://mcnair.siu.edu/_common/documents/recommendation-
form.pdf
☐Most recent copy of your FAFSA Student Aid Report (SAR)
☐Most recent copy of IRS Tax Return
☐SIU Unofficial Transcript
☐Signed Information Release Form
Woody Hall C117 | Mail Code 4719 900 S. Normal Avenue |Carbondale, IL 62901
Website: mcnair.siu.edu| phone: 618.453.4582|fax: 618.453.4596| email: rseymour@siu.edu
Please Type APPLICATION
1. PERSONAL INFORMATION
Name: _______________________________________________________________________________________
Last First Full Middle Name
SIU ID#: ___________________________________________
Date of Birth (MM/DD/YYYY): _____________________________
Gender: ☐Male ☐Female ☐Other
Current Housing (check one): ☐Off-campus ☐At home with parent/guardian ☐On campus Student
Address:_____________________________________________________________________________________
Permanent Address: __________________________________________________________________________
Street
____________________________________________________________________________
City State Zip
Home Phone #: _________________________________________
Cell Phone #:___________________________________________
SIU Email Address: _____________________________________________________________________
(Note: We will contact you via SIU email)
Personal Email Address: _______________________________________________________________
Racial/Ethnic Data:
1. Are you Hispanic or Latinx? ☐No ☐Yes
2. How do you identify your race/ethnicity? Select all that apply:
☐American Indian or Alaskan Native ☐Native Hawaiian or Pacific Islander
☐Asian ☐White
☐Black or African American
2. ACADEMIC INFORMATION
Are you a transfer student? ☐No ☐Yes; if Yes, name of institution:_______________________________
Academic Load: ☐Full-time ☐Part-time
SIU Major (1): ____________________________ SIU Major (2): ____________________________
SIU Minor (1): ____________________________ SIU Minor (2): ____________________________
SIU Current GPA: __________/4.0 SIU Cumulative GPA: __________/4.0 Total Semester Hours Earned: __________
Academic Standing (select one): ☐Freshmen ☐Sophomore ☐ Junior ☐Senior
Do you plan to study abroad? ☐NO ☐YES; If “Yes”,when?:_____________________________
Anticipated Graduation (MM/YYYY): _________________
Website: mcnair.siu.edu| phone: 618.453.4582|fax: 618.453.4596| email: rseymour@siu.edu
Please Type
Academic Goals:
1) Are you interested in pursuing graduate/doctoral education? ☐No ☐Yes ☐Maybe
2) Type of degree: ☐Masters ☐Doctoral (Ph.D. or Ed.D) ☐Juris Doctorate (J.D.)
☐Medical Degree (M.D.) ☐Masters of Business Administration (M.B.A.)
3) What type of academic program do you plan to pursue in graduate school? ___________________________________
4) Do you have research experience? ☐No ☐Yes
If so, please provide the name of the faculty for the project or the name of the program.
__________________________________________________________________________________________
Undergraduate Research Interests:
Please list two research topics/projects related to your major that interest you.
1)__________________________________________________________________________________________
2)__________________________________________________________________________________________
Potential Undergraduate Research Faculty Mentors (optional):
Please identify two potential faculty mentors conducting research in an area in your major.
1)_______________________________________________________________________________________________
First Name Last Name Department Email Address
2)______________________________________________________________________________________________
First Name Last Name Department Email Address
3. ELIGIBILTY REQUIREMENTS:
Citizenship:
☐U.S. Citizen ☐Permanent Resident; what is your Permanent Resident Alien Number? A________________
First-generation Status:
What is your father’s highest educational degree?
☐Less than K-12 ☐High School Diploma ☐Associate’s Degree ☐Bachelor’s
☐Master’s ☐Doctorate
What is Your Mother's highest educational degree?
☐Less than K-12 ☐High School Diploma ☐Associate’s Degree ☐Bachelor’s
☐Master’s ☐Doctorate
Which parent did you regularly reside with and receive support from prior to the age of 18 (Check one only)?
☐Mother (natural or adoptive)
☐Father (natural or adoptive)
☐Both Mother and Father
☐Neither Mother nor Father
Family Income: * If you are an INDEPENDENT student, only include your taxable income and your dependents, if
applicable.
A. What was your Family’s Household Taxable Income for the previous year? $________________
(Line 6 on 1040EZ / Line 27 on 1040A / Line 43 on 1040)
B. What is the total number of persons (including you) in your family? _______________________
4. OTHER INFORMATION
Dependency Verification:
To determine whether you are a DEPENDENT or INDEPENDENT student, please answer the following:
1) Are you 24 years or older? ☐YES ☐NO
2) Are you a veteran of the U.S. Armed Forces? ☐YES ☐NO
3) Are you married? ☐YES ☐NO
4) Do you have children or other dependents (other than a spouse) who receive more than half of their support from you?
☐YES ☐NO
5) At any time since reaching 13 years of age, were you an orphan, in foster care, or a ward of the court?
☐YES ☐NO
6) Prior to reaching 18 years of age, were you an emancipated minor or did you have a court appointed legal guardian?
☐YES ☐NO
7) Are you serving on active duty in the U.S. Armed Forces? ☐YES ☐No
8) Are you less than 18 years of age and have no parent or guardian? ☐YES ☐NO
9) Are you homeless (i.e., you lack a fixed, regular, & adequate nighttime residence) or are at risk of becoming
homeless? ☐YES ☐NO If homeless, list length of time: ______________________________
TRiO Programs:
Have you participated in any TRiO programs or other U.S. Department of Education programs?
If Yes, please give name of university/program:
Upward Bound ☐No ☐Yes: _____________________________
Student Support Services: ☐No ☐Yes: _____________________________
McNair Scholars Program: ☐No ☐Yes: _____________________________
Upward Bound Math and Science: ☐No ☐Yes: _____________________________
Educational Talent Search: ☐No ☐Yes: _____________________________
Educational Opportunity Centers: ☐No ☐Yes: _____________________________
GEAR UP ☐No ☐Yes: _____________________________
University Programs:
Are you a current or past participant in any of these programs?
☐Undergraduate Assistantship ☐REACH ☐ILSAMP
☐First Scholars ☐University Honors ☐SI Bridges
How did you find out about the McNair Scholars Program?
☐Information Table ☐Current SIU Student ☐Website ☐Information Session
☐Former SIU Student Email ☐SIU Faculty ☐SIU Staff ☐Flyer
Other: ________________________________________
Employment Information:
Do you currently have or plan to obtain employment this academic year? ☐Yes ☐No
If “Yes”, will you be working: ☐Full-time ☐Part-time Hours per week: ______
Where:_____________________________________________________________________________
5. TWO ESSAYS
A. Personal/Professional Statement (2 pages):
Please include a two page statement, one inch margins, double space, and 12 point font. Use this essay as an
opportunity for the admissions committee to learn more about you and your background. DO NOT use lists or bullets in
your personal/professional statement.
Your statement should address the following areas:
• Your personal and family background and what motivated you to pursue a college education.
• Your personal attributes and professional skills that will enable you to achieve your goals, including any
weakness or obstacles that may be a challenge to your success.
• Your ultimate educational and career goals, including why you are interested in attending graduate school.
• What you hope to accomplish by participating in the SIUC McNair Scholars Program.
B. Statement of Research Experiences and Interests (up to 1 page):
Type on a separate sheet of paper a statement describing your research interests. Discuss the academic area in which
you would like to conduct research if selected as McNair Scholar. Provide an example of a specific topic or questions
you want to explore. This could be a topic you learned about in class.
Do not include an abstract or proposal.
6. RESUME
Please provide a one-page resume in the following format. I. Name and Basic Contact Information. II. Education. III.
Employment. IV. Academic Honors, Scholarships, and Awards, V. Memberships and Outreach (including
leadership positions and volunteer hours) and VI. Academic/Enrichment Experiences research activities, study
abroad, and other experiences that demonstrate your commitment to academic excellence and scholarship.
7. LETTERS OF RECOMMENDATIONS
Two letters of recommendation are required; at least two letters should be solicited from faculty members who have
knowledge of your academic performance, research experiences, and/or professional goals. See separate
Recommendation Form. Your recommendations can be mailed directly to the McNair Office or placed in a signed
envelope and included in your application packet. Once received, these confidential references will become the property
of the McNair Program. Provide contact information for each of your references.
Name:__________________________________________________ Title:_____________________________________
Institution:______________________________________________ Email:____________________________________
Name:__________________________________________________ Title:_____________________________________
Institution:______________________________________________ Email:____________________________________
8. MCNAIR SCHOLARS PROGRAM RELEASE
This release form enables the McNair Scholars Program at Southern Illinois University Carbondale to obtain copies of all
academic and financial aid records, including transcripts, grade reports, financial aid eligibility, and other information
pertaining to my eligibility and participation in the McNair Program. This information may be shared with other
university personnel to determine your eligibility and to monitor your academic progress in accordance with federal
regulations and university policy.
I understand that a copy of my application form will be kept on file at the McNair Scholars Program office and that the
resulting information received will be used to complete the annual performance report as required by the U.S.
Department of Education. The information on this form is required and is strictly confidential. Once accepted into the
program, I understand that the U.S. Department of Education requires the McNair Program staff to track my post-
baccalaureate enrollment and degree attainment for ten years in.
I give my permission for the program staff members to request this information from this and future institutions for
follow-up purposes, as well as permission to request this information through a third party, like the National Student
Clearinghouse after my enrollment in the program has ended. Once accepted into the program, I grant permission for the
McNair Scholars Program to use my name, photographs, or likenesses of myself in various print and online publications
I hereby certify to the best of my knowledge that all information submitted is complete and accurate. I understand that
failure to disclose information or falsification of information, are grounds for not being accepted to the SIU McNair
Scholar Program and if accepted into the program grounds for immediate termination.
Print Applicant’s Name: _____________________________________________________
Applicant’s Signature: _____________________________________________________ Date: ___________________
Udtd 09/2018
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signature
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Version 03/2019
Woody Hall 347 / Mail Code 4719
900 S.
Normal Ave., Carbondale, IL 62901
phone 618-453-4582 / fax 618-453-4596
mcnair.siu.edu
Applicant First and Last Names: _____________________________________ Student ID #: ___________________
Optional Waiver: I voluntarily waive all rights to review this letter of recommendation conferred by The Family
Education Rights & Privacy Act of 1974.
Applicant Signature: _________________________________________________ Date: ______________________
The person named above is applying to the SIU Carbondale McNair Scholars Program. We are a federally funded program
that encourages graduate study and preparation. We provide participants with a mentored research experience, seminars,
and workshops on topics related to the pursuit of the doctoral degree. We would appreciate your honest evaluation of the
applicant's personality, character, and professional and academic promise. In your statement, please discuss the applicant's
strengths and weaknesses and give the basis of your opinion. We wish to select bright and motivated students who will
benefit from our program. Thank you for taking the time to complete this form and the letter of recommendation.
How long have you known the applicant and in what capacity?
I consider the student to be _____ Ready _____ Ready, if mentored _____ Not ready to conduct research
and explore doctoral study.
VERY GOOD GOOD FAIR NOT APPLICABLE
Please evaluate the student in the following categories:
Academic potential
Critical thinking
Maturity
Organization & expression of ideas
Commitment to academic goals
Ability to work with others
Willing to accept constructive feedback
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
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Please attach a letter detailing addition information that will give us a greater understanding of the applicant and his/her
potential as a graduate student and researcher.
Name: ________________________________________________________________________________________
Title: ____________________________________________ Department: __________________________________
Email Address: _______________________________________________ Date: _____________________________
Please return the completed recommendation to: McNair Scholars Program 900 S. Normal Ave. Mail Code 4719. Carbondale, IL 62901.
For information, please contact Rhetta Seymour, Interim Director at 618/453-4582 or rseymour@siu.edu.
FACULTY RECOMMENDATION FORM
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signature
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Version 03/2019
Woody Hall 347 / Mail Code 4719
900 S.
Normal Ave., Carbondale, IL 62901
phone 618-453-4582 / fax 618-453-4596
mcnair.siu.edu
Applicant First and Last Names: _____________________________________ Student ID #: ___________________
Optional Waiver: I voluntarily waive all rights to review this letter of recommendation conferred by The Family
Education Rights & Privacy Act of 1974.
Applicant Signature: _________________________________________________ Date: ______________________
The person named above is applying to the SIU Carbondale McNair Scholars Program. We are a federally funded program
that encourages graduate study and preparation. We provide participants with a mentored research experience, seminars,
and workshops on topics related to the pursuit of the doctoral degree. We would appreciate your honest evaluation of the
applicant's personality, character, and professional and academic promise. In your statement, please discuss the applicant's
strengths and weaknesses and give the basis of your opinion. We wish to select bright and motivated students who will
benefit from our program. Thank you for taking the time to complete this form and the letter of recommendation.
How long have you known the applicant and in what capacity?
I consider the student to be _____ Ready _____ Ready, if mentored _____ Not ready to conduct research
and explore doctoral study.
VERY GOOD GOOD FAIR NOT APPLICABLE
Please evaluate the student in the following categories:
Academic potential
Critical thinking
Maturity
Organization & expression of ideas
Commitment to academic goals
Ability to work with others
Willing to accept constructive feedback
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
Please attach a letter detailing addition information that will give us a greater understanding of the applicant and his/her
potential as a graduate student and researcher.
Name: ________________________________________________________________________________________
Title: ____________________________________________ Department: __________________________________
Email Address: _______________________________________________ Date: _____________________________
Please return the completed recommendation to: McNair Scholars Program 900 S. Normal Ave. Mail Code 4719. Carbondale, IL 62901.
For information, please contact Rhetta Seymour, Interim Director at 618/453-4582 or rseymour@siu.edu.
FACULTY RECOMMENDATION FORM
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APPLYING TO SIU McNAIR SCHOLARS PROGRAM (Southern Illinois University-Carbondale)

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Completed 19 August 2021

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