3. How has engaging in this undergraduate research ...



THE CUNY RESEARCH SCHOLARS PROGRAMatQueensborough Community College 2016-2017 Application Form COVER PAGETitle of Research Project: ______________________________________________________Name of Faculty Mentor:___________________________________________________ Affiliation (title/department): ________________________________________________E-mail: __________________________________Phone Number: __________________Please indicate your previous participation in the CUNY Research Scholars Program (check all that apply): _ First time CUNY Research Scholar(s) faculty mentor_ 2015-2016 CUNY Research Scholar(s) faculty mentor_ 2014-2015 CUNY Research Scholar(s) faculty mentorPlease indicate your student mentee’s previous participation in the CUNY Research Scholars Program (check all that apply): _ First time CUNY Research Scholar_ 2015-2016 CUNY Research Scholar_ 2014-2015 CUNY Research ScholarNOTE TO FACULTY MENTOR: Your name should not appear on the remaining pages of this document. Cover pages will be removed before the review process starts and titles of research projects will be used as identifiers afterwards. PROPOSED RESEARCHTitle of Research Project: Description of Research Project (include the specific role of the student mentee in the proposed research project):The proposed project must provide a laboratory-based research experience to the student. Please indicate the type of laboratory environment (e.g. science lab, computer lab, technology lab) and the location (may be off-campus) of the facility where the research will be conducted:Project Timeline:Does the research project require IRB (Y/N)? If yes, indicate the status of your application for IRB approval (i.e. approved, submitted and pending approval, in preparation):Please list any additional sources of funding -pending or approved- for this project (indicate type and amount of support, i.e. faculty or student stipend, travel funds, supplies, etc)FACULTY MENTOR COMPLETE THIS SECTIONAffiliation (title/department): ___________________________________________________Experience mentoring undergraduate research students: ____ No ____Yes, at QCC or other institution: __________________________________Above mentoring experiences have led to (check all that apply):____ Student presentations to peers or student clubs within the college____ Student presentations at local or regional professional conferences ____ Student presentations at national conferences____ Publications co-authored by studentFor how long have you known the student you plan to mentor and in what capacity? If the student was a previous CUNY Research Scholar under your guidance please include what motivates you to continue to work with this student?CUNY Research Scholars Program - <ENTER Title of Research Project HERE> STUDENT INFORMATIONName: ____________________________________________________________________E-mail: ____________________________________CUNYFirst ID __________________Status: Freshman _______ Lower sophomore _______ Upper sophomore _______Major at QCC: ______________________________________ Current GPA: ________ Expected graduation date: ___________________Date of Birth: ______________________________Current gender identity: How do you describe yourself? __ Male __ Female __ Transgender __ Gender variant/non-conforming __Not listed __ Prefer not to answerPlease indicate race and ethnicity (check all that apply): ____ White____ Black or African American____ Asian ____ American Indian and Alaska Native ____ Hawaiian/Pacific Islander ____ Hispanic, Latino, or Spanish origin____ Other: ____________________CUNY Research Scholars Program - <ENTER Title of Research Project HERE>STUDENT STATEMENT OF INTEREST(Max. 300 words)Include your academic background, interest in this particular research project and your current career plans. To be completed only by students who are participating for a second or third year in the program. This page should not be completed by first time student applicants.STUDENT REFLECTION AND STATEMENT OF INTERESTRe-enrolling students must write an essay reflecting on his/her experience in the program, the next steps in his/her academic career and how participation in the program for a second year will be beneficial. The following prompts are meant to guide (but not limit) the scholar’s reflection. 1. Describe your overall experience in the program 1.1 List the activities in which you participated1.2 Provide a summary of skills acquired1.3 List your accomplishments, including but not limited to presentations of your research1.4 Other (if any)2. What is “the most valuable lesson” learned while participating in the program?3. How has engaging in this undergraduate research experience impacted your academic career at Queensborough? How has it impacted your future academic and/or professional goals?4. How can a second year in the program help you to build on or better understand your previous research, and/or achieve the aforementioned goals? ................
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