Center for Emergent Materials at Ohio State University



Application for the Academic Year Columbus State Community College Research Program

Deadline October 1st

Please return application to Ms. Michelle McCombs in 2006 PRB or mccombs.75@osu.edu

Name: email:

Phone (best number to reach you): Address while at school:

Home / Cell (please circle one)

Expected graduation date:

Degree area at CSCC: Overall GPA: Current GPA in major:

Major/Minor upon transfer:

Ethnicity: ____African American Gender: M / F Declared Disability: Y / N ____Asian

____Caucasian

____Hispanic

____Native American

Other____________________

| | |

|What is the highest level of formal education obtained by your parents? Mark one circle for each parent. | |

| |Father |Mother |

|Some high school |O |O |

|High school graduate |O |O |

|Some college but no degree |O |O |

|Two-year college degree — Associate’s |O |O |

|Four-year college degree – Bachelor’s |O |O |

|Some graduate school |O |O |

|Master’s |O |O |

|Professional degree (e.g., medicine, law) |O |O |

|Doctorate |O |O |

|Other |O |O |

Which faculty labs would you like to work in?

Please attach a brief letter of support from a faculty member that knows you well and can ideally speak to your abilities to work in a research laboratory.

Please describe your career goals and how the REU experience with the Center for Emergent Materials would be meaningful to you:

Please attach an Unofficial Transcript and a Resume with other information about your activities and accomplishments.

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