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