2010 Summer Undergraduate Research Experience

School of Polymers and High Performance Materials,
The University of Southern Mississippi
Tuesday, June 1st – Friday, August 6th, 2010

APPLICATION

Completed application along with official transcripts and two letters of recommendation must be received by March 19, 2010. Please have transcripts and recommendation letters sent to:

Kimberly Wingo,
Outreach Coordinator, Department of Polymer Science
University of Southern Mississippi
118 College Dr. #10076
Hattiesburg, MS 39406-0076

Personal Information

First and Last Name


Email Address


Month/Day/Year of Birth

Male Female

Ethnic Origin


U.S. Citizen
Yes No

If not a U.S. Citizen, Permanent Resident
Yes No

School mailing address
City State Zip

Phone Number

Permanent home address
City State Zip

Permanent phone number

Academic Information

Undergraduate Institution

Major

Current GPA

Expected Graduation Date

Applicant must arrange to have official transcript(s) sent by March 12, 2010.

Please list completed chemistry, polymer, physics, biochemistry, and biology courses and final grades.

Course Grade
Course Grade
Course Grade
Course Grade
Course Grade
Course Grade

Previous Research Experience

Please describe pertinent research experiences.

Personal Statement

In the space below, please briefly describe your career goals and how participation in the Research Experience for Undergraduates in the Center for Response-Driven Polymeric Film will help you in attaining these goals.

If you desire, please provide other information that you think might be important. Include science related hobbies and outside activities indicating your skills and leadership abilities.




I certify that the above information is correct. If accepted for this program, I agree to participate for the entire ten week summer period and will not accept any other form of remuneration.

Date Electronic Signature

I Retain / Waive my right of access the accompanying letter of recommendation.