Marine Models in Biological Research Undergraduate Summer Program at the Marine Biological Laboratory, Woods Hole, MA
Application 2004

DEADLINE: Completed application forms, all transcripts, and evaluations must be received by March 1, 2004. Decisions of the Admissions Committee will be communicated in mid-Marchl.
Return all application documents to: Carole Browne, Biology Department, Wake Forest University, Winston-Salem, NC 27109.

Name, Last: ________________________First:_____________________Middle Initial:_________

Participants will be supported with National Science Foundation funds and must be citizens or permanent residents of the United States or its
possessions. Can you, after acceptance, verify your U.S. citizenship or permanent residency status?  [ ]Yes   [ ] No   

Social Sec. #:__________________________
 
INSTITUTIONAL ADDRESS:

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City:___________________________State:__________

Country:                                 Postal Code:________

Telephone : _______________________________ 

E-mail:__________________________________ 
 

 HOME ADDRESS:

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________________________________________ 

City:__________________________State:___________

Country:                                   Postal Code:________

Telephone : _______________________________ 

E-mail:___________________________________ 
 
 PLEASE INDICATE WHICH MAILING ADDRESS IS PREFERRED
(Note – most information will be communicated by e-mail unless you indicate otherwise)

EDUCATION

Current Institutional Affiliation:_____________________________________________________

_______________________________________________________________________________

Current Status: Freshman____ Sophomore____ Junior____ Senior____ Other ____(please explain)

Degree earned or expected:________ Year:_________ Field of Concentration:_________________

How did you learn about this course:____________________________________________________

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Marine Models in Biological Research Program Summer 2004 Application, page 2

SUPPORT MATERIALS: All materials listed below must be enclosed with this form or submitted separately in order for your application to be complete. Items received after March 1, 2004 cannot be guaranteed consideration by the course Admissions Committee.

o STATEMENT OF GOALS (One-page description of your goals for the next three years related to your reasons for wanting to take this course).

o SUMMARY OF RESEARCH EXPERIENCE

o STATEMENT OF YOUR EXPECTATIONS FOR THE PROGRAM (What you anticipate this experience to be like and what you expect to gain from attending.)

EVALUATIONS: Applicants should request written evaluations from two individuals familiar with their academic and research background and goals.. Sealed evaluations may be submitted with other application materials by the candidate, or sent directly to the course directors by the evaluator. Students are advised that the two required evaluations should not come from faculty members of the course to which they are applying. Recommendations from course faculty members may, however, be submitted as supplemental third evaluations.

Please provide the names and institution of the individuals whom you will ask to submit evaluations

Name:__________________________________Institution:__________________________________________

Name:__________________________________Institution:__________________________________________

Name:__________________________________Institution:__________________________________________

TRANSCRIPTS: Undergraduate transcripts are required. Although official copies are not required, originals should be submitted.
Please list below the institution(s) from which you will be submitting or requesting transcripts:

____________________________________________________________________________________________

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Please note: Summer courses at the Marine Biological Laboratory are extremely rigorous, requiring complete student participation in all aspects of the program for the full duration. Students attend morning lectures five or six days per week, often followed by small group discussions. There are also frequent guest lectures in the evenings. Afternoons and, often, weekends are devoted to research. Please be aware of this as you prepare the statements requested of you above.

OPTIONAL INFORMATION (For U.S. Citizens and Permanent Residents only) If you are a member of an under-represented minority in science, please indicate below.

____African-American ____Hispanic ____Native American ____Multiracial