Fillable Reu Application Form (University of Southern Mississippi)

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Reu Application Form (University of Southern Mississippi)

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Course Grade Course Grade
I certify that the above information is correct.
Name:____________________________ Date:_________________
Sensing and Assembly Based on Non-Covalent Interactions
2020 Summer Research Experience for Undergraduates (REU)
Chemistry and Biochemistry, The University of Southern Mississippi
APPLICATION
First Name:_________________ Last Name:___________________
Date of Birth:________________ Gender: _______
Race/Ethnicity :_________________ Resident Status: ________________
Address: ________________________________________
City: _____________________ State: ___________ Zip code: ___________
Telephone:_______________________ Cell Phone:______________________
Permanent Address:_____________________________________________________________
Current college or university:______________________________________________________
Major:______________________ Cumulative GPA:________ Chem GPA:_________
Year of Study (as in March 2020): _____________ Expected graduationate: ___________
Do you plan to attend graduate school? (Yes, No, Undecided?) _________
If yes, chemistry, biochemistry, other? __________
Do you plan to attend medical school? (yes, no) ___________
Please identify your top three preferences for REU research groups:
1st: ____________________________________________________
2nd: ____________________________________________________
3rd: ____________________________________________________
Relevant college courses and grade (chemistry, physics, calculus courses):
African American
US citizen
Sophomore
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Reu Application Form (University of Southern Mississippi)

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Completed 30 August 2020

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