Application form to register for the

Southern Miss Department of Chemistry and Biochemistry

Summer Undergraduate Research Experience

When you have completed the form, please click on the "Submit Query" button located at the bottom of the form. The contents of the form will be automatically E-mailed to Ms. Sharon King, the SURE adminiatrative assistant. Please note that your application is not complete until we have received your college transcript and two letters of reference from college faculty. Please note that current USM students are not eligible for the SURE program.

If you do not receive confirmation of your application in a few days please contact Ms. King by email at sharon.king@usm.edu or by telephone at 601-266-4711.

Review of applications will begin as they are received and will continue until all positions are filled. Only students that have completed organic chemistry by the summer term and are US citizens or permanent residents will be considered.

Basic Information

Full Name:

School Address (including school name):

Your telephone number at school, preferably your cell phone:

Your telephone number at home:

Your E-mail address:

Your major:

Overall GPA:

Chemistry GPA:

Citizenship Status:

Your anticipated graduation date:

Faculty references including name, title, telephone numbers, and email addresses:
(Note that these must be professors who have taught you in a class or supervised your research.)

reference 1:

reference 2:

Please write a paragraph about your educational and career goals:

Please review the SURE faculty and indicate your top three choices for a research advisor.

Top choice:

Second choice:

Third choice:

If you are accepted into the program, would you be:

driving or flying to Hattiesburg

bringing your laptop