Northwestern University



NSF Demographic Analysis Questionnaire- NOTE: Failure to complete this questionnaire DOES NOT affect your application -Select the option or options that you identify as: FORMCHECKBOX American Indian or Alaskan Native (including all Original Peoples of the Americas) FORMCHECKBOX Asian (including Indian subcontinent and Philippines) FORMCHECKBOX Native Hawaiian or Pacific Islander (Original Peoples) FORMCHECKBOX Black or African American (including Africa and Caribbean) FORMCHECKBOX Hispanic FORMCHECKBOX White (non-Hispanic, including Middle Eastern) FORMCHECKBOX Other ___________ FORMCHECKBOX Prefer not to answerGender: FORMCHECKBOX Female FORMCHECKBOX Male FORMCHECKBOX Other ____________ FORMCHECKBOX Prefer not to answerBackgroundAre you a first-generation college student? FORMTEXT ?????Application Questions1. Are you a US Citizen or permanent resident? FORMTEXT ?????2. Will you be available to be on Northwestern’s campus for at least 9 weeks during Summer 2021, starting June 21st: FORMCHECKBOX Yes FORMCHECKBOX No3. Spring academic term end date: FORMTEXT ?????Fall academic term start date: FORMTEXT ?????4. Class standing for the 2020-2021 school year (e.g. Sophomore): FORMTEXT ?????Expected graduation date: FORMTEXT ?????5. Current academic affiliation: FORMTEXT ?????Major: FORMTEXT ?????6. Does your current academic institution have a PhD program in any of the following STEM areas (check all that apply): FORMCHECKBOX Chemistry/Biochemistry/Chemical Biology FORMCHECKBOX Biology (any) FORMCHECKBOX Physics/Biophysics FORMCHECKBOX Chemical Engineering FORMCHECKBOX Bioengineering/Biomedical Engineering FORMCHECKBOX Computer Science/Computer Engineering FORMCHECKBOX Environmental Science/Engineering FORMCHECKBOX Other ____________________7. If you are at a community college, what is your anticipated year of transfer? FORMTEXT ?????8. Overall GPA: FORMTEXT ?????Science/Math/Engineering GPA: FORMTEXT ?????9.List all science and math courses taken and grades earned, including those you are enrolled in now (no grades required for courses in progress):10. Are you considering an additional, advanced degree after you complete your Bachelor’s degree? FORMTEXT ?????For each of the following, rate your interest on a scale of 1 to 5 where 1 is extremely interested and 5 is not at all interested:a. Business (MBA) FORMTEXT ?????b. Medicine (MD, DO) FORMTEXT ?????c. Pharmacy (PharmD) FORMTEXT ?????d. Dentistry (DDS) FORMTEXT ?????e. Engineering (MS/PhD) FORMTEXT ?????f. Science (MS/PhD) FORMTEXT ?????g. Law (JD) FORMTEXT ?????h. Other – please list FORMTEXT ????? 11.Do you plan on applying to graduate school at Northwestern? FORMTEXT ?????12.If not planning on applying to graduate school, what are your plans post-graduation (e.g. industry, consulting, etc.)? 13. Faculty Mentor. Read through the research directions for each of the Center for Synthetic Biology members on . Then, rank your top 3 choices of potential faculty mentor in terms of your current interests with 1 as most interested:1. ________________________2. ________________________3. ________________________14.How did you find out about this program? Check all that apply: FORMCHECKBOX Flyer FORMCHECKBOX Email FORMCHECKBOX Website FORMCHECKBOX Friend FORMCHECKBOX Instructor/mentor FORMCHECKBOX Other ____________________Essay Questions: The first two essays are required of all applicants. We recommend you type the essays in this form, but will also accept scanned, hand-written forms.1. What is your current career goal or aspiration upon completion of your academic studies? Would you like to go into industry, business, medicine, government, or something else? How might this summer program impact or support your your goal? If possible, please describe the unique strengths you will bring to the program, and/or what challenges you have overcome to get to where you are now. (200-500 words)2. Why are you interested in synthetic biology research and this program in particular? Looking at the list of potential faculty mentors in question 13 of the prior section, what interests you about their research? (200-500 words)3. Have you had any prior research experience? FORMCHECKBOX Yes FORMCHECKBOX NoIf you answered “Yes”, tell us briefly about that experience, and include where you worked (include the PI, if applicable), the topic of your research, any skills you gained, and what you learned about yourself from that experience. (200-300 words) ................
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