Application -- Due March 2, 1998
Undergraduate Summer Research
Opportunities in Physics
at Ohio State University: REU/OSU
June 15 -- August 21, 1998
| _________________________________ | ____________________________ |
| Name | Date |
| _________________________________ | ___________________________ |
| Home Address | Address while at school |
| _________________________________ | ___________________________ |
| _________________________________ | ___________________________ |
| Home City, State, Zipcode | School City, State, Zipcode |
| _________________________________ | __________________________ |
| Telephone Number (Home) | Telephone Number (School) |
| _________________________________ | ___________________________ |
| Social Security Number | Email Address |
| ______________________________________________________________________ | |
| Emergency Contact, with phone number and address | |
Are you a US citizen or permanent resident? ___Are you a member of a minority group?____
Date of birth_________
Present College or University and Dates Attended:
Past College or University and Dates Attended:
Major:____________________________
Current Class Standing (Freshman, Sophomore, Junior, Senior):__________________
Current GPA in Math and Physics__________
Honors or Awards:
Please list the Physics courses you have completed and your grades in each course:
Please give your previous laboratory or other research experience, if any:
Please indicate why you are interested in the OSU/REU program and how you intend to benefit from it:
(You may wish to submit the answer to this question as an essay on a separate page.)
References: Please request letters of reference or support from two people who are familiar with your scientific background and preparation, and please give them the attached forms.
My references will be from:
Name Institution Title
1.______________________________________________________
2.______________________________________________________
Return all forms to: OSU/REU Summer Institute
Department of Physics
The Ohio State University
Columbus, OH 43210
Attention: Shirley Royer