Summer Schools in Nuclear and Radiochemistry

Undergraduate Fellowship Program
Division of Nuclear Chemistry and Technology
American Chemical Society

Sponsored by the U.S. Department of Energy


 

Please complete in full the application form below. In addition to the application form, official transcript(s) and two letters of recommendation should be sent to:

Prof. Paul Mantica, Director
ACS Nuclear Chemistry Summer Schools
Department of Chemistry
Michigan State University
East Lansing, MI 48824
email: mantica@msu.edu
FAX: 517-353-5967

Deadline for receipt of all application materials is February 1, 2010

 

Application Form:

 

Personal Information

Last Name: First Name:
Sex: Male      Female
Current Address: Permanent Address:
City: City:
State: State:
Zip/Postal Code: Zip/Postal Code:
Phone: Phone:
Fax:
E-mail:
Birthdate (YYYY-MM-DD):
Place of Birth (City, State): Country of Birth:

  U.S. Citizen:     Yes      No (Applicant must be a U.S. citizens to qualify for this program)
Academic Information

School Presently Attending:
School Location:
Major:
Expected Graduation Date:      
Current Status:
Current GPA Science GPA
SAT or ACT Scores     Verbal Math

Have you taken or am now taking Physical Chemistry?     Yes     No

Have you taken or am now taking Physics?     Yes     No

Honors and Awards

Program Information

If selected for this program, what is your site preference?     Eastern     Western     None

Want College Credit?     Yes     No

If no, please explain

How did you learn about this program?    
Interests and Educational Goals

Describe you interest in, and how you would benefit from, this program (Please limit to less than 200 words).

Describe your educational and career goals (Please limit to less than 200 words).

By selecting the submit button, I certify that the above information is accurate and understand that any misrepresentation may be cause for refusal of admission to the program

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