On-line application form

Please fill out the following form to complete the online application. If you do not receive a confirmation e-mail within 5 business days of submission please contact us.

You can also send your application via regular mail. The forms can be downloaded in pdf format. Please click here to download the forms.

Send to: Molecular Genetics and Biochemistry REU

984 Biological Sciences Building

484 W. 12th Ave.

Columbus, OH 43210

APPLICATION FORM FOR 2008 MG-REU PROGRAM

You will be asked to list your top 3 lab choices in question 17. Please visit the faculty research description page to review the list of faculty and their focus areas before you start filling out the form.

1- Last name:

First name:

2- Gender: Female Male

3- Permanent mailing address:

4- Home phone number:

5- Current University or College:

.....mailing address:

6- Daytime phone number:

7- Evening phone number:

8- Current e-mail address:

9- Major:

10- GPA:

11- Current class rank:
freshman sophomore junior senior

12- Expected graduation date (mm/yy):

13- Please select all that apply from the following:

White, Non-Hispanic
African American
Hispanic origin (any race)
Asian or Pasific Islander
American Indian, Eskimo or Aleut
Other

1st in the family to go to college

14- List two recommenders for references. Please direct your recommender to the following link "REFEREE FORM " for electronic submission.

Recommender 1:

E-mail & phone number of Ref #1

Recommender 2:

E-mail & phone number of Ref #2

15- Do you have any research experience? If yes please explain briefly.

16- In the space below briefly explain your plans after graduation.

17- Please list your 3 top choices of research labs. A list of faculty and labs as well as links to faculty web pages can be located on the faculty page.

1st choice:

2nd choice:

3rd choice: